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Organization

IMPERIAL HEALTH LLP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TONYA RICHARD (CHIEF OPERATING OFFICER)
(337) 312-8360
Entity
Organization

Contact information

Practice address
4150 NELSON RD, BLDG D STE 1, LAKE CHARLES, LA 70605-4133
(337) 508-1000
Mailing address
501 DR MICHAEL DEBAKEY DR, LAKE CHARLES, LA 70601-5724
(337) 312-8360
(337) 312-6708

Taxonomy

Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary

Other

Enumeration date
03/20/2023
Last updated
05/17/2023
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