Organization
DOC 4 KIDS
Active
Other names
Doc 4 Kids
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARMEN ENID KOUBICEK M.D. (PRESIDENT)
(337) 407-0084
Entity
Organization
Contact information
Practice address
1270 ATTAKAPAS DR STE 401 K, OPELOUSAS, LA 70570-6549
(337) 407-0084
(337) 407-0094
Mailing address
1270 ATTAKAPAS DR STE 401 K, OPELOUSAS, LA 70570-6549
(337) 407-0084
(337) 407-0094
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
L#13448R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1565911
—
LA
01
—
1992855282
INDIVIDUAL NPI
LA
01
—
L#13448R
MED LICENSE
LA
Enumeration date
04/12/2007
Last updated
08/22/2020
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