Organization
CARDIO-THORACIC SURGERY PA A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BETINA M BREAUX MT BB (OFFICE MANAGER)
(985) 882-6221
Entity
Organization
Contact information
Practice address
64040 HWY 434, SUITE 100, LACOMBE, LA 70445
(985) 882-6221
(985) 882-7935
Mailing address
64040 HWY 434, SUITE 100, LACOMBE, LA 70445
(985) 882-6221
(985) 882-7935
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09015239
—
MS
05
—
1440221
—
LA
Enumeration date
08/18/2006
Last updated
09/04/2013
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