Healthcare Provider Details

I. General information

NPI: 1750804068
Provider Name (Legal Business Name): DANIEL BARTHOLOMEW FOY III
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2017
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2053 GAUZE BLVD E STE 150
SLIDELL LA
70641
US

IV. Provider business mailing address

2053 GAUZE BLVD E STE 150
SLIDELL LA
70461
US

V. Phone/Fax

Practice location:
  • Phone: 504-352-9755
  • Fax: 985-646-1005
Mailing address:
  • Phone: 504-352-9755
  • Fax: 985-646-1005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: