Organization
CHRISTUS HEALTH SOUTHWESTERN LOUISIANA
Active
Other names
COMBRE-FONDEL ELEMENTARY SBHC
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL TREVINO (CEO)
(409) 899-8191
Entity
Organization
Contact information
Practice address
2115 FITZENREITER RD, LAKE CHARLES, LA 70601-1139
(337) 439-0880
(337) 439-0887
Mailing address
524 DR MICHAEL DEBAKEY DR, LAKE CHARLES, LA 70601-5725
(337) 439-0880
(337) 439-0887
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447749
—
LA
Enumeration date
05/03/2007
Last updated
07/05/2022
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