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General NPI Number Information
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NPI Number | 1306086806
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Entity Type | Organization
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Legal Business Name | TOTAL CARE SERVICES
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Dates
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Enumeration Date | 02/24/2009
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Last Update Date | 02/24/2009
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Provider Practice Location Address
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Address Line | 3000 KINGMAN ST SUITE 100
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City | METAIRIE
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State | LA
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Zip | 70006-6636
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Country | US
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Telephone | 504-454-6050
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Fax | 504-454-6051
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Provider Business Mailing Address
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Address Line | 3000 KINGMAN ST SUITE 100
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City | METAIRIE
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State | LA
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Zip | 70006-6636
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Country | US
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Telephone | 504-454-6050
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Fax | 504-454-6051
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Authorized Official
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Title or Position | PRESDIDENT
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Name | JUAN CARLOS MARTINEZ
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Credential |
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Telephone | 504-454-6050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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