Organization
IMPERIAL HEALTH LLP
Active
Other names
Vein Center of Southwest Louisiana
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEITH D BROACH (CEO/PRESIDENT)
(337) 990-5510
Entity
Organization
Contact information
Practice address
1700 KALISTE SALOOM RD, BLDG 2, STE 201, LAFAYETTE, LA 70508-6112
(337) 534-8346
Mailing address
501 DR MICHAEL DEBAKEY DR, LAKE CHARLES, LA 70601-5724
(337) 433-8400
(337) 312-6708
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Enumeration date
05/16/2014
Last updated
05/16/2014
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