=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841482445
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PERMANAND S. J. BEEHARILAL MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/16/2007
-----------------------------------------------------
Last Update Date | 03/07/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4242 HIGHWAY 19 STE A
-----------------------------------------------------
City | ZACHARY
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70791
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 225-286-4360
-----------------------------------------------------
Fax | 225-286-4363
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4242 HIGHWAY 19 STE A
-----------------------------------------------------
City | ZACHARY
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70791-3982
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 225-286-4360
-----------------------------------------------------
Fax | 225-286-4363
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261Q00000X
-----------------------------------------------------
Taxonomy Name | Clinic/Center
-----------------------------------------------------
License Number | MD203580
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | MD203580
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------