MEDICARE: HALIE ORY MPAS, PA-C

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	363A00000X	Physician Assistant	300215	LA
2	363AM0700X	Medical Physician Assistant	300215	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972974400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HALIE ORY MPAS, PA-C

Provider Business Mailing Address
First Line	:	184 WILLIAMSBURG ST
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70605-5720
Country	:	US
Telephone Number	:	337-437-4014
Fax Number	:	337-437-8283

Provider Business Practice Location Address
First Line	:	184 WILLIAMSBURG ST
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70605-5720
Country	:	US
Telephone Number	:	337-437-4014
Fax Number	:	337-437-8283

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

Provider Enumeration Date	:	10/09/2015
Last Update Date	:	12/17/2025

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Directions to “ HALIE ORY MPAS, PA-C” Practice Location

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