Organization
IMPERIAL HEALTH LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONYA RICHARD (ASSISTANT ADMINSTRATOR)
(337) 312-8291
Entity
Organization
Contact information
Practice address
250 BEGLIS PKWY, SUITE 1, SULPHUR, LA 70663-3500
(337) 626-7630
(337) 626-8409
Mailing address
501 DR MICHAEL DEBAKEY DR, LAKE CHARLES, LA 70601-5724
(337) 433-8400
(337) 312-6708
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
LA
208100000X
Physical Medicine & Rehabilitation Physician
—
LA
213E00000X
Podiatrist
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CI9478
RAILROAD MEDICARE GROUP
LA
Enumeration date
11/01/2006
Last updated
01/16/2017
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