MEDICARE: GHYASS RIZK MD,ENDOCRINE CLINIC OF LOUISIANA, APMC

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	207RE0101X	Endocrinology, Diabetes & Metabolism Physician

General Provider Information

NPI Number	:	1770530339
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GHYASS RIZK MD,ENDOCRINE CLINIC OF LOUISIANA, APMC

Provider Business Mailing Address
First Line	:	200 LA RUE FRANCE
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70508-3104
Country	:	US
Telephone Number	:	337-264-9787
Fax Number	:	337-264-9506

Provider Business Practice Location Address
First Line	:	200 LA RUE FRANCE
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70508-3104
Country	:	US
Telephone Number	:	337-264-9787
Fax Number	:	337-264-9506

Authorized Official
Title or Position	:	OWNER
Name	:	DR. GHYASS RIZK
Credential	:	MD
Telephone Number	:	337-264-9787

Provider Enumeration Date	:	05/28/2006
Last Update Date	:	10/26/2022

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