Healthcare Provider Details

I. General information

NPI: 1053711887
Provider Name (Legal Business Name): TRANSAFRICAN DEVELOPMENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2014
Last Update Date: 08/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 PALMER ST
WELSH LA
70591-4320
US

IV. Provider business mailing address

PO BOX 1015
LAKE CHARLES LA
70602-1015
US

V. Phone/Fax

Practice location:
  • Phone: 713-292-8739
  • Fax:
Mailing address:
  • Phone: 713-292-8739
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StateLA
# 4
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number StateLA

VIII. Authorized Official

Name: MR. VICTOR ELOKAN NDANDO-NGOO
Title or Position: FOUNDER/CEO
Credential: M.A.
Phone: 713-292-8739