Organization
HAROLD G BIENVENU III MD, APMC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HAROLD G BIENVENU III M.D.,APMC (OWNER)
(337) 439-2040
Entity
Organization
Contact information
Practice address
711 DR MICHAEL DEBAKEY DR, STE # 100, LAKE CHARLES, LA 70601-5785
(337) 439-2040
(337) 439-2042
Mailing address
711 DR MICHAEL DEBAKEY DRIVE, STE # 100, LAKE CHARLES, LA 70601-5785
(337) 439-2040
(337) 439-2042
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
015116
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015116
STATE LICENSE
LA
Enumeration date
05/25/2006
Last updated
04/02/2012
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