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General NPI Number Information
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NPI Number | 1407068299
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Entity Type | Organization
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Legal Business Name | CHRISTUS HEALTH SOUTHWESTERN LOUISIANA
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 07/05/2022
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Provider Practice Location Address
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Address Line | 753 OAK GROVE HWY
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City | GRAND CHENIER
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State | LA
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Zip | 70643-3242
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Country | US
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Telephone | 337-542-4441
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Fax | 337-542-4588
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Provider Business Mailing Address
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Address Line | 524 DR MICHAEL DEBAKEY DR
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City | LAKE CHARLES
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State | LA
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Zip | 70601-5725
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Country | US
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Telephone | 337-542-4441
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Fax | 337-542-4588
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Authorized Official
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Title or Position | CEO
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Name | PAUL TREVINO
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Credential |
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Telephone | 409-899-8191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1000X
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Taxonomy Name | Student Health Clinic/Center
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License Number |
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License Number State |
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