Individual
LATA K THALY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1978 INDUSTRIAL BLVD, LEONARD CHABERT MEDICAL CENTER, HOUMA, LA 70363
(985) 873-2200
Mailing address
72 LAKEWOOD ESTATES DR, NEW ORLEANS, LA 70131-8358
(504) 228-2077
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
14514
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1325791
—
LA
Enumeration date
05/31/2006
Last updated
10/04/2012
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