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General NPI Number Information
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NPI Number | 1699148882
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Entity Type | Organization
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Legal Business Name | BOPP DERMATOLOGY AND FACIAL PLASTIC SURGERY
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Dates
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Enumeration Date | 11/10/2015
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 3421 N CAUSEWAY BLVD 102
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City | METAIRIE
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State | LA
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Zip | 70002
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Country | US
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Telephone | 504-455-9933
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Fax |
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Provider Business Mailing Address
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Address Line | 3421 N CAUSEWAY BLVD STE 102
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City | METAIRIE
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State | LA
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Zip | 70002-3711
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Country | US
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Telephone | 504-455-9933
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | SUE LYNN RESENDEZ
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Credential |
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Telephone | 504-455-9933
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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 | 202381
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License Number State | LA
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