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General NPI Number Information
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NPI Number | 1912214743
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Entity Type | Organization
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Legal Business Name | NEUROPATHY PAIN CENTERS OF KENNER, LLC
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Dates
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Enumeration Date | 08/31/2010
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Last Update Date | 08/31/2010
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Provider Practice Location Address
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Address Line | 1919 VETERANS MEMORIAL BLVD STE 102
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City | KENNER
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State | LA
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Zip | 70062-4003
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Country | US
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Telephone | 504-464-9114
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Fax | 504-464-9115
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Provider Business Mailing Address
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Address Line | 1184 W PIONEER PKWY
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City | ARLINGTON
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State | TX
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Zip | 76013-6367
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Country | US
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Telephone | 817-860-1005
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Fax | 817-860-5010
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Authorized Official
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Title or Position | ACCT MGR
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Name | JENNIFER HODGES
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Credential |
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Telephone | 817-860-1005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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