Organization
DURA MATER, INC
Active
Other names
bryant g. george, sr. m.d.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYANT GERARD GEORGE SR. M.D. (CEO)
(985) 690-0135
Entity
Organization
Contact information
Practice address
700 GAUSE BLVD, SUITE 201, SLIDELL, LA 70458-2800
(985) 690-0135
(985) 690-0136
Mailing address
700 GAUSE BLVD, SUITE 201, SLIDELL, LA 70458-2800
(985) 690-0135
(985) 690-0136
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
018940
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1378356
—
LA
Enumeration date
05/25/2007
Last updated
08/22/2020
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