# MOBILE X-RAY OF LOUISIANA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326102633
- **Authorized official:** MR. JEREMY A. HEBERT (MANAGER)
- **Authorized official phone:** (337) 233-1987

## Contact information

- **Practice address:** 1021 COOLIDGE BLVD., LAFAYETTE, LA 70503-0000
- **Practice address phone:** (337) 412-6702
- **Practice address fax:** (337) 504-2158
- **Mailing address:** 910 HARDING ST, LAFAYETTE, LA 70503-2450
- **Mailing address phone:** (337) 412-6702
- **Mailing address fax:** (337) 504-2158

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | — | NULL | — |
| 174400000X | Specialist | — | — | — |
| 261QR0208X | Mobile Radiology Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/20/2006
- **Last updated:** 11/18/2009