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General NPI Number Information
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NPI Number | 1528942620
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Entity Type | Organization
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Legal Business Name | CASLCASIEU SURGICAL ANESTHESIA, LLC
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Dates
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Enumeration Date | 08/01/2025
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 5150 ROBOTICS LN
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City | LAKE CHARLES
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State | LA
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Zip | 70605-5284
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Country | US
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Telephone | 337-214-2900
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Fax |
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Provider Business Mailing Address
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Address Line | 5150 ROBOTICS LN
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City | LAKE CHARLES
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State | LA
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Zip | 70605-5284
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Country | US
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Telephone | 337-214-2900
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JENNY BONO
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Credential | FACHE
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Telephone | 337-214-1591
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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