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General NPI Number Information
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NPI Number | 1265521710
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Entity Type | Individual
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Provider Name | FIDEL FABIAN SENDRA MD
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Gender | Male
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 02/17/2025
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Provider Practice Location Address
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Address Line | 3311 PRESCOTT RD STE 312
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City | ALEXANDRIA
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State | LA
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Zip | 71301-3984
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Country | US
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Telephone | 318-443-0490
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 321359
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City | FLOWOOD
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State | MS
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Zip | 39232-1359
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Country | US
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Telephone | 601-936-1395
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Fax | 601-933-6596
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 13230R
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License Number State | LA
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