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NPI Code Detail

MEDICARE: HAROLD G BIENVENU III MD, APMC

MEDICARE: HAROLD G BIENVENU III MD, 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
1207YS0123XFacial Plastic Surgery Physician015116LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1015116OTHERLASTATE LICENSE

General Provider Information

NPI Number : 1982650503
Entity Type Code : Organization
Provider Name (Legal Business Name) : HAROLD G BIENVENU III MD, APMC
Provider Business Mailing Address
First Line : 711 DR MICHAEL DEBAKEY DRIVE
Second Line : STE # 100
City : LAKE CHARLES
State : LA
Zip : 70601-5785
Country : US
Telephone Number : 337-439-2040
Fax Number : 337-439-2042
Provider Business Practice Location Address
First Line : 711 DR MICHAEL DEBAKEY DR
Second Line : STE # 100
City : LAKE CHARLES
State : LA
Zip : 70601-5785
Country : US
Telephone Number : 337-439-2040
Fax Number : 337-439-2042
Authorized Official
Title or Position : OWNER
Name : HAROLD G BIENVENU III
Credential : M.D.,APMC
Telephone Number : 337-439-2040
Provider Enumeration Date : 05/25/2006
Last Update Date : 04/02/2012

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