# BRYAN A PICOU ET AL PTR

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Family Medical Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962574111
- **Authorized official:** BRYAN ANTHONY PICOU MD (OWNER)
- **Authorized official phone:** (318) 352-2971

## Contact information

- **Practice address:** 740 KEYSER AVE, SUITE A, NATCHITOCHES, LA 71457-6037
- **Practice address phone:** (318) 352-2971
- **Mailing address:** 740 KEYSER AVE, SUITE A, NATCHITOCHES, LA 71457-6037
- **Mailing address phone:** (318) 352-2971

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | LA | Yes |

## Other

- **Enumeration date:** 11/14/2006
- **Last updated:** 07/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1001236 | — | LA |