Organization
M.D.PHYSICIAN BILLING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEMETRA BURKHALTER (CEO)
(972) 505-6087
Entity
Organization
Contact information
Practice address
3251 WALL BLVD, 1703, GRETNA, LA 70056-8631
(504) 300-7277
Mailing address
3251 WALL BLVD, 1703, GRETNA, LA 70056-8631
(504) 300-7277
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
261QC1500X
Community Health Clinic/Center
—
—
Other
Enumeration date
08/14/2014
Last updated
08/14/2014
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