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General NPI Number Information
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NPI Number | 1689825499
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Entity Type | Organization
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Legal Business Name | LOUISIANA CARDIOVASCULAR AND LIMB SALVAGE CENTER, APMC
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Dates
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Enumeration Date | 10/10/2008
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Last Update Date | 07/09/2020
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Provider Practice Location Address
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Address Line | 4811 AMBASSADOR CAFFERY PARKWAY SUITE 401A
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City | LAFAYETTE
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State | LA
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Zip | 70508
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Country | US
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Telephone | 337-456-6523
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Fax | 337-456-6521
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Provider Business Mailing Address
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Address Line | 901 WILSON ST
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City | LAFAYETTE
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State | LA
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Zip | 70503-2439
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Country | US
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Telephone | 337-456-6523
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Fax | 337-456-6521
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Authorized Official
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Title or Position | CFO
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Name | SAMUEL DAVID ABRAHAM
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Credential |
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Telephone | 337-456-6525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | MD07649R
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number |
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License Number State | LA
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