| Magnificent Minds Telemed | |
|
630 W Cornerview St Ste B Gonzales LA 70737-2742 | |
| (225) 647-4105 | |
| Not Available |
| Full Name | Magnificent Minds Telemed |
|---|---|
| Speciality | Psychiatry & Neurology - Child & Adolescent Psychiatry |
| Location | 630 W Cornerview St Ste B, Gonzales, Louisiana |
| Authorized Official Name and Position | Demarcus Patterson (OWNER) |
| Authorized Official Contact | 5049080715 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Magnificent Minds Telemed Po Box 359 Gonzales LA 70707-0359 Ph: (504) 915-0705 | Magnificent Minds Telemed 630 W Cornerview St Ste B Gonzales LA 70737-2742 Ph: (225) 647-4105 |
| NPI Number | 1275255309 |
|---|---|
| Provider Enumeration Date | 09/15/2022 |
| Last Update Date | 09/15/2022 |
| Certification Date | 09/15/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275255309 | NPI | - | NPPES |
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