Individual
BEDFORD NIEVES CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8166 MAIN ST, HOUMA, LA 70360-3404
(985) 873-4141
(985) 851-4307
Mailing address
8166 MAIN ST, HOUMA, LA 70360-3404
(985) 226-6428
(985) 858-7335
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD11360R
LA
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
MD.11360R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02286071
—
MS
05
—
1664324
—
LA
01
—
370007352
RAILROAD MEDICARE
—
Enumeration date
04/07/2006
Last updated
06/27/2018
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