Organization
CARDIOVASCULAR INSTITUTE OF THE SOUTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICKOLAS C ZAUNBRECHER (CHIEF FINANCIAL OFFICER)
(337) 291-4834
Entity
Organization
Contact information
Practice address
225 DUNN ST, HOUMA, LA 70360-4413
(985) 876-0300
(985) 872-0317
Mailing address
PO BOX 4176, HOUMA, LA 70361-4176
(985) 876-0300
(985) 872-0317
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RI0011X
Interventional Cardiology Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
363AS0400X
Surgical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1795119
—
LA
01
—
CS0290
RR MEDICARE
LA
Enumeration date
12/09/2005
Last updated
04/27/2023
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