| The Psychiatric Medicine Institute Of La Llc | |
|
850 Kaliste Saloom Rd Ste 115 Lafayette LA 70508-4230 | |
| (337) 264-1991 | |
| (337) 264-1993 |
| Full Name | The Psychiatric Medicine Institute Of La Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 850 Kaliste Saloom Rd, Lafayette, Louisiana |
| Authorized Official Name and Position | Charles Houma Dixon Bowers (OWNER) |
| Authorized Official Contact | 3372641991 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Psychiatric Medicine Institute Of La Llc 850 Kaliste Saloom Rd Ste 115 Lafayette LA 70508-4230 Ph: (337) 264-1991 | The Psychiatric Medicine Institute Of La Llc 850 Kaliste Saloom Rd Ste 115 Lafayette LA 70508-4230 Ph: (337) 264-1991 |
| NPI Number | 1023047776 |
|---|---|
| Provider Enumeration Date | 07/02/2006 |
| Last Update Date | 03/31/2008 |
| Medicare PECOS PAC ID | 1759394224 |
|---|---|
| Medicare Enrollment ID | O20060731000013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023047776 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Charles Bowers |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407888704 PECOS PAC ID: 7012920580 Enrollment ID: I20060731000026 |
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