Organization
DR. BRUCE S. SAMUELS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL PEREZ (ADMIN. ASST.)
(985) 871-4910
Entity
Organization
Contact information
Practice address
189 GREENBRIAR BLVD, SUITE C, COVINGTON, LA 70433-7234
(985) 871-8920
(985) 871-9796
Mailing address
PO BOX 1847, COVINGTON, LA 70434-1847
(985) 871-4910
(985) 871-9796
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
012831
LA
174400000X
Specialist
013678
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1795704
—
LA
Enumeration date
02/16/2007
Last updated
06/07/2013
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