Organization
LOUISIANA MEDSHIELD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEAU PORCHE D.C. (AUTHORIZED OFFICIAL/OWNER)
(985) 873-8586
Entity
Organization
Contact information
Practice address
430 CORPORATE DR STE A, HOUMA, LA 70360-2514
(985) 333-1421
(985) 262-4651
Mailing address
430 CORPORATE DR STE A, HOUMA, LA 70360-2514
(985) 333-1421
(985) 262-4651
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Enumeration date
04/22/2019
Last updated
03/25/2020
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