=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174478101
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CENLACARE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/04/2026
-----------------------------------------------------
Last Update Date | 03/04/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5101 HIGHWAY 28 EAST
-----------------------------------------------------
City | PINEVILLE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71360-4738
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 318-542-4441
-----------------------------------------------------
Fax | 318-542-4431
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4501 JACKSON ST EXT STE C355
-----------------------------------------------------
City | ALEXANDRIA
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71303-2555
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 318-528-5131
-----------------------------------------------------
Fax | 318-524-7024
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN/OWNER
-----------------------------------------------------
Name | MOHAMMED S AZIZ
-----------------------------------------------------
Credential | DO
-----------------------------------------------------
Telephone | 318-528-5131
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------