NPI 1760643670

Neuromedical Clinic of Cenla,l.L.C.

Organisation Preferred Provider Organization Alexandria, LA

Practice location

Address: 3311 Prescott Rd Suite 216, Alexandria, LA 71301-3900
Phone: (318) 443-0490
Fax: (318) 443-0690

Authorised official

Name: Gonzalo Ivar Hidalgo
Title: Owner/Physician
Phone: (318) 443-0490

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 025214 (LA)

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Registry record

NPI: 1760643670
Entity type: Organization
NPI issued: 23 Jun 2008
Record last updated: 23 Jun 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.