Healthcare Provider Details

I. General information

NPI: 1225636129
Provider Name (Legal Business Name): VASCULAR & INTERVENTIONAL RADIOLOGY OF SIOUXLAND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2020
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 W STEAMBOAT DR STE 601
DAKOTA DUNES SD
57049-5287
US

IV. Provider business mailing address

345 W STEAMBOAT DR STE 601
DAKOTA DUNES SD
57049-5287
US

V. Phone/Fax

Practice location:
  • Phone: 605-217-5617
  • Fax: 605-217-5533
Mailing address:
  • Phone: 605-217-5617
  • Fax: 605-217-5533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. CHAD R LAURICH
Title or Position: PRESIDENT
Credential: MD
Phone: 605-217-5617