Organization
LAKE CHARLES MEDICAL SERVICES, INC
Active
Other names
Endocrinology Center of SWLA
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID BRIAN USHER FACHE (V.P. OF OPERATIONS)
(337) 494-3202
Entity
Organization
Contact information
Practice address
2770 3RD AVE STE 345, LAKE CHARLES, LA 70601-8994
(337) 494-4765
(337) 494-4766
Mailing address
PO BOX 1907, LAKE CHARLES, LA 70602-1907
(337) 494-2919
(337) 494-2947
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06-00010290
OCCUPATIONAL LICENSE
LA
Enumeration date
09/13/2006
Last updated
08/22/2020
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