Organization
LAFAYETTE HEART CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER T MALLAVARAPA MD (MD/OWNER)
(337) 261-0928
Entity
Organization
Contact information
Practice address
5000 AMBASSADOR CAFFERY PKWY, PROVINCE BUILDING 1, LAFAYETTE, LA 70508
(337) 261-0928
(337) 233-7773
Mailing address
5000 AMBASSADOR CAFFERY PKWY, PROVINCE, BUILDING 1, LAFAYETTE, LA 70508
(337) 261-0928
(337) 233-7773
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207UN0901X
Nuclear Cardiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1448460
—
LA
Enumeration date
05/17/2007
Last updated
09/12/2013
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