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General NPI Number Information
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NPI Number | 1578843199
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Entity Type | Organization
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Legal Business Name | DEEPAK & MEENU, LLC
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Dates
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Enumeration Date | 08/26/2011
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Last Update Date | 08/26/2011
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Provider Practice Location Address
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Address Line | 211 4TH STREET RAPIDES WOUND HEALING CENTER
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City | ALEXANDRIA
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State | LA
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Zip | 71301
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Country | US
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Telephone | 318-769-4509
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Fax | 318-769-4510
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Provider Business Mailing Address
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Address Line | 6205 TENNYSON OAKS LN
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City | ALEXANDRIA
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State | LA
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Zip | 71301-2759
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Country | US
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Telephone | 318-484-2680
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DEEPAK SHARMA
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Credential | M.D.
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Telephone | 318-484-2680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 12275R
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License Number State | LA
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