Organization
IMPERIAL HEALTH, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONYA RICHARD (ASSISTANT ADMINISTRATOR)
(337) 312-8291
Entity
Organization
Contact information
Practice address
501 DR MICHAEL DEBAKEY DR, LAKE CHARLES, LA 70601-5724
(337) 433-8400
(337) 312-6708
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
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
53
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1966983
—
LA
Enumeration date
11/08/2006
Last updated
01/16/2017
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