Organization
IMPERIAL HEALTH LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TONYA RICHARD (ASSISTANT ADMINISTRATOR)
(337) 312-8291
Entity
Organization
Contact information
Practice address
200 W 5TH STREET, DERIDDER, LA 70634
(337) 436-3813
(337) 439-0214
Mailing address
501 DR MICHAEL DEBAKEY DR, LAKE CHARLES, LA 70601-5724
(337) 312-8420
(337) 312-6708
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Enumeration date
10/10/2019
Last updated
10/10/2019
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