Organization
CARDIOVASCULAR AND THORACIC SURGICAL SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FIDEL F SENDRA M.D. (PRESIDENT)
(985) 641-6150
Entity
Organization
Contact information
Practice address
71380 HIGHWAY 21, SUITE 104, COVINGTON, LA 70433-7245
(985) 893-5639
(985) 893-5641
Mailing address
P O BOX 8660, MANDEVILLE, LA 70470-8660
(985) 893-5639
(985) 893-5641
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD13230R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09015757
—
MS
05
—
1446505
—
LA
Enumeration date
07/19/2007
Last updated
03/20/2012
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