Whalio Doctors

NPI 1134304330

Bayou Home Bureau

Organisation PACE Provider Organization Bastrop, LA

Practice location

Address
8057 Williard Rd, Bastrop, LA 71220-8939
Phone
(318) 556-0043
Fax
(318) 556-3633
Mailing address
8057 Williard Rd PO Box 561, Bastrop, LA 71220-8939

Authorised official

Name
Juanetta Martin
Title
Owner
Phone
(318) 556-0043

Registered specialties

PACE Provider Organization Primary
Agencies Taxonomy 251T00000X Licence PCA8246 (LA)

Registry record

NPI
1134304330
Entity type
Organization
NPI issued
7 Jan 2008
Record last updated
7 Jan 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.