MEDICARE: CARDIOMED CLINIC LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician		LA

General Provider Information

NPI Number	:	1457676132
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARDIOMED CLINIC LLC

Provider Business Mailing Address
First Line	:	64040 HIGHWAY 434
Second Line	:	SUITE 101
City	:	LACOMBE
State	:	LA
Zip	:	70445-3499
Country	:	US
Telephone Number	:	985-882-8488
Fax Number	:	985-882-8487

Provider Business Practice Location Address
First Line	:	64040 HIGHWAY 434
Second Line	:	SUITE 101
City	:	LACOMBE
State	:	LA
Zip	:	70445-3499
Country	:	US
Telephone Number	:	985-882-8488
Fax Number	:	985-882-8487

Authorized Official
Title or Position	:	OWNER
Name	:	DR. UMESH A PATEL
Credential	:	M.D.
Telephone Number	:	985-882-8488

Provider Enumeration Date	:	04/06/2010
Last Update Date	:	03/31/2014

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Directions to “CARDIOMED CLINIC LLC ” Practice Location

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