Organization
OCEANS ROG LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STUART J ARCHER (CEO)
(972) 464-0022
Entity
Organization
Contact information
Practice address
302 W MCNEESE ST, LAKE CHARLES, LA 70605-5604
(337) 210-4477
Mailing address
3905 HEDGCOXE RD UNIT 250249, PLANO, TX 75025-0840
(972) 464-0022
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2396714
—
LA
01
—
357168
PTAN
LA
01
—
357171
PTAN
LA
Enumeration date
03/10/2014
Last updated
06/01/2023
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