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General NPI Number Information
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NPI Number | 1104267301
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Entity Type | Organization
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Legal Business Name | CHRISTUS HEALTH SOUTHWESTERN LOUISIANA
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Dates
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Enumeration Date | 07/16/2013
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Last Update Date | 07/16/2013
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Provider Practice Location Address
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Address Line | 1614 WOLF CIR
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City | LAKE CHARLES
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State | LA
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Zip | 70605-2348
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Country | US
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Telephone | 337-478-9653
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Fax | 337-474-0988
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Provider Business Mailing Address
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Address Line | 524 DR MICHAEL DEBAKEY DR
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City | LAKE CHARLES
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State | LA
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Zip | 70601-5725
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Country | US
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Telephone | 337-491-7730
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Fax | 337-491-7157
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Authorized Official
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Title or Position | CEO
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Name | MR. STEPHEN WRIGHT
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Credential |
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Telephone | 337-448-6584
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 647
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License Number State | LA
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