# ST. LUKE'S DIAGNOSTIC CLINIC OF LAKE CHARLES, L.L.C.

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

## Provider details

- **NPI number:** 1699789529
- **Authorized official:** DR. BRYAN P BARRILLEAUX M.D. (OWNER)
- **Authorized official phone:** (337) 439-2000

## Contact information

- **Practice address:** 643 S RYAN ST, LAKE CHARLES, LA 70601-5726
- **Practice address phone:** (337) 439-2000
- **Practice address fax:** (337) 439-2025
- **Mailing address:** 643 S RYAN ST, LAKE CHARLES, LA 70601-5726
- **Mailing address phone:** (337) 439-2000
- **Mailing address fax:** (337) 439-2025

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 017896 | LA | Yes |

## Other

- **Enumeration date:** 07/28/2006
- **Last updated:** 08/22/2020