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General NPI Number Information
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NPI Number | 1538331301
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Entity Type | Organization
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Legal Business Name | HOUMA DIAGNOSTIC CLINIC
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Dates
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Enumeration Date | 04/01/2008
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Last Update Date | 04/01/2008
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Provider Practice Location Address
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Address Line | 601 DUNN ST
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City | HOUMA
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State | LA
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Zip | 70360-4707
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Country | US
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Telephone | 985-868-6404
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Fax | 985-868-6405
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Provider Business Mailing Address
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Address Line | 601 DUNN ST
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City | HOUMA
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State | LA
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Zip | 70360-4707
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Country | US
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Telephone | 985-868-6404
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Fax | 985-868-6405
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEPHEN E HELLMAN
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Credential | MD
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Telephone | 985-868-6404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | 011195
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License Number State | LA
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