Individual
GARETT R ISTRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
N.P.
Contact information
Practice address
1747 IMPERIAL BLVD, LAKE CHARLES, LA 70605-5362
(337) 721-7236
Mailing address
501 DR MICHAEL DEBAKEY DR, LAKE CHARLES, LA 70601-5724
(337) 312-8360
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP08181
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2383248
—
LA
Enumeration date
02/05/2015
Last updated
06/04/2015
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