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General NPI Number Information
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NPI Number | 1083711006
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Entity Type | Organization
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Legal Business Name | CARDIOVASCULAR SPECIALISTS OF SOUTHWEST LOUISIANA, LLC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 06/10/2014
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Provider Practice Location Address
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Address Line | 600 DR MICHAEL DEBAKEY DR
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City | LAKE CHARLES
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State | LA
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Zip | 70601-5727
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Country | US
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Telephone | 337-493-4345
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Fax | 337-493-4355
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Provider Business Mailing Address
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Address Line | 600 DR MICHAEL DEBAKEY DR
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City | LAKE CHARLES
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State | LA
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Zip | 70601-5727
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Country | US
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Telephone | 337-493-4345
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Fax | 337-493-4355
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. CHRISTNE HINTON
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Credential |
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Telephone | 337-493-4345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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