Organization
LEESVILLE CARDIOVASCULAR CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GEETHA M MATHEW (DIRECTOR)
(337) 392-2211
Entity
Organization
Contact information
Practice address
1101A PORT ARTHUR TER, LEESVILLE, LA 71446-4635
(337) 392-2211
(337) 392-2210
Mailing address
1101A PORT ARTHUR TER, LEESVILLE, LA 71446-4635
(337) 392-2211
(337) 392-2210
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
11538R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1675024
—
LA
01
—
DD4050
RAILROAD MEDICARE #
LA
Enumeration date
03/15/2006
Last updated
03/16/2010
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