Individual
JIMMY LAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1990 INDUSTRIAL BLVD, HOUMA, LA 70363-7055
(985) 868-9300
(985) 851-0053
Mailing address
1990 INDUSTRIAL BLVD, HOUMA, LA 70363-7055
(985) 868-9300
(985) 851-0053
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
10229R
LA
2080P0206X
Pediatric Gastroenterology Physician
10229R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1998222
—
LA
Enumeration date
06/07/2006
Last updated
02/20/2013
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