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General NPI Number Information
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NPI Number | 1912165341
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Entity Type | Organization
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Legal Business Name | CHILDRENS HEALTH CENTER, LLC
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Dates
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Enumeration Date | 06/02/2008
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Last Update Date | 06/02/2008
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Provider Practice Location Address
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Address Line | 3521 HIGHWAY 190 STE N
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City | EUNICE
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State | LA
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Zip | 70535-5135
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Country | US
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Telephone | 337-550-1175
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Fax | 337-550-1176
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Provider Business Mailing Address
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Address Line | 3521 HIGHWAY 190 STE N
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City | EUNICE
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State | LA
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Zip | 70535-5135
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Country | US
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Telephone | 337-550-1175
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Fax | 337-550-1176
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | TODD H. PULLIN
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Credential | M.D.
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Telephone | 337-550-1175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 022507
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License Number State | LA
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