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Organization

PRIDE PLAZA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. WARTELLE J CASTILLE MD (OWNER / OPERATOR)
(337) 237-6712
Entity
Organization

Contact information

Practice address
850 N PIERCE ST, LAFAYETTE, LA 70501-2848
(337) 237-6712
(337) 234-1906
Mailing address
850 N PIERCE ST, LAFAYETTE, LA 70501-2848
(337) 237-6712
(337) 234-1906

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
201660
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1075850
LA
Enumeration date
03/12/2010
Last updated
03/12/2010
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