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General NPI Number Information
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NPI Number | 1588645303
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Entity Type | Organization
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Legal Business Name | TCHEFUNCTE CARDIOVASCULAR ASSOCIATES
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Dates
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Enumeration Date | 11/09/2005
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Last Update Date | 04/03/2008
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Provider Practice Location Address
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Address Line | 101 E FAIRWAY DR SUITE 504
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City | COVINGTON
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State | LA
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Zip | 70433-7503
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Country | US
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Telephone | 985-871-8227
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Fax | 985-871-6920
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Provider Business Mailing Address
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Address Line | 101 E FAIRWAY DR SUITE 504
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City | COVINGTON
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State | LA
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Zip | 70433-7503
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Country | US
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Telephone | 985-871-8227
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Fax | 985-871-6920
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Authorized Official
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Title or Position | PRESIDENT
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Name | GABRIEL LASALA
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Credential | M.D.
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Telephone | 985-871-8227
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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