MEDICARE: TA'RAE FLAGG

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	3747P1801X	Personal Care Attendant	NA	LA

General Provider Information

NPI Number	:	1871435503
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TA'RAE FLAGG

Provider Business Mailing Address
First Line	:	5615 JACKSON ST BLDG L
Second Line	:
City	:	ALEXANDRIA
State	:	LA
Zip	:	71303-2326
Country	:	US
Telephone Number	:	318-448-1801
Fax Number	:	318-448-1841

Provider Business Practice Location Address
First Line	:	5615 JACKSON ST BLDG L
Second Line	:
City	:	ALEXANDRIA
State	:	LA
Zip	:	71303-2326
Country	:	US
Telephone Number	:	318-448-1801
Fax Number	:	318-448-1841

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2026
Last Update Date	:	04/09/2026

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1164620357 — DAVID M. REMEDIOS APMC
Practice Location Address:

5615 JACKSON STREET EXT , BUILDING E.
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Directions to “ TA'RAE FLAGG ” Practice Location

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