Organization
PHCA HOUMA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WAYNE L WILIAMS JR. (CFO)
(214) 763-1184
Entity
Organization
Contact information
Practice address
435 CORPORATE DR STE 402, HOUMA, LA 70360-2498
(985) 400-3019
(985) 400-3021
Mailing address
119 E MAIN ST STE 200, LAFAYETTE, LA 70501-6921
(214) 763-1184
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
02/11/2020
Last updated
07/23/2020
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