Organization
CARDIOVASCULAR DIAGNOSTIC CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIRGINIA Y GONZALEZ M.D. (OWNER)
(318) 338-3540
Entity
Organization
Contact information
Practice address
402 MCMILLAN RD, WEST MONROE, LA 71291-5326
(318) 338-3540
(318) 335-3542
Mailing address
402 MCMILLAN RD, WEST MONROE, LA 71291-5326
(318) 338-3540
(318) 335-3542
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
11314R
LA
207RI0011X
Interventional Cardiology Physician
11314R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1667781
—
LA
Enumeration date
02/05/2007
Last updated
12/30/2012
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