Individual
TYLER JORDAN ZACHARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1727 IMPERIAL BLVD BLDG 2, LAKE CHARLES, LA 70605-5393
(337) 310-3670
(337) 421-1408
Mailing address
501 DR MICHAEL DEBAKEY DR, LAKE CHARLES, LA 70601-5724
(433) 337-8400
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
324348
LA
Other
Enumeration date
06/16/2015
Last updated
03/22/2021
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