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General NPI Number Information
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NPI Number | 1295447365
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Entity Type | Individual
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Provider Name | EMERITE COMBOY PUJOL PA
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Gender | Female
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Dates
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Enumeration Date | 12/20/2022
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Last Update Date | 03/22/2023
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Provider Practice Location Address
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Address Line | 1057 PAUL MAILLARD RD
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City | LULING
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State | LA
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Zip | 70070-4349
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Country | US
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Telephone | 985-785-6242
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Fax |
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Provider Business Mailing Address
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Address Line | 145 REX DR
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City | NEW ORLEANS
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State | LA
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Zip | 70123-3530
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Country | US
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Telephone |
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 335562
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License Number State | LA
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