Organization
SELIM SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NIAZY MAHMOUD SELIM MD, PHD, FACS (PRESIDENT/CEO)
(337) 502-8706
Entity
Organization
Contact information
Practice address
215 W PRIEN LAKE RD, SUITE B, LAKE CHARLES, LA 70601
(337) 502-8706
(337) 210-1271
Mailing address
215 W PRIEN LAKE RD, LAKE CHARLES, LA 70601-8450
(337) 502-8706
(337) 210-1271
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
MD207592
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2388533
—
LA
Enumeration date
09/06/2018
Last updated
07/03/2024
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