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General NPI Number Information
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NPI Number | 1255994125
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Entity Type | Organization
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Legal Business Name | IMPERIAL HEALTH, LLP
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Dates
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Enumeration Date | 04/17/2019
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Last Update Date | 04/17/2019
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Provider Practice Location Address
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Address Line | 1327 STELLY LANE SUITE 3
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City | SULPHUR
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State | LA
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Zip | 70663
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Country | US
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Telephone | 337-310-3670
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Fax | 337-421-1408
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Provider Business Mailing Address
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Address Line | 501 DR MICHAEL DEBAKEY DR
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City | LAKE CHARLES
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State | LA
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Zip | 70601-5724
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Country | US
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Telephone | 337-312-8420
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Fax | 337-312-6708
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Authorized Official
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Title or Position | ASSISTANT ADMINISTRATOR
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Name | MRS. TONYA C RICHARD
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Credential | CMPE
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Telephone | 337-312-8291
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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