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General NPI Number Information
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NPI Number | 1417250846
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Entity Type | Individual
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Provider Name | KEVIN J TATE ARDMS RVT RCS ARRT
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Gender | Male
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Dates
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Enumeration Date | 12/07/2010
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Last Update Date | 12/07/2010
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Provider Practice Location Address
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Address Line | 335 GRANT RD
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City | OPELOUSAS
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State | LA
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Zip | 70570-0745
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Country | US
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Telephone | 337-945-4953
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Fax | 866-390-5469
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Provider Business Mailing Address
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Address Line | 335 GRANT RD
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City | OPELOUSAS
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State | LA
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Zip | 70570-0745
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Country | US
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Telephone | 337-945-4953
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Fax | 866-390-5469
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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 | 246XS1301X
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Taxonomy Name | Sonography Specialist/Technologist Cardiovascular
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License Number | 81840
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 2471V0105X
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Taxonomy Name | Vascular Sonography Radiologic Technologist
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License Number | 00026985
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License Number State | LA
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