| St Jude Medical Group Llc | |
|
4150 Nelson Rd Bldg E Suite 4 Lake Charles LA 70605-4148 | |
| (337) 564-6722 | |
| Not Available |
| Full Name | St Jude Medical Group Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 4150 Nelson Rd, Lake Charles, Louisiana |
| Authorized Official Name and Position | Jude Agendia (OWNER) |
| Authorized Official Contact | 3375646722 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St Jude Medical Group Llc 4150 Nelson Rd Bldg E Suite 4 Lake Charles LA 70605-4148 Ph: () - | St Jude Medical Group Llc 4150 Nelson Rd Bldg E Suite 4 Lake Charles LA 70605-4148 Ph: (337) 564-6722 |
| NPI Number | 1396086211 |
|---|---|
| Provider Enumeration Date | 03/04/2013 |
| Last Update Date | 03/04/2013 |
| Medicare PECOS PAC ID | 3779722665 |
|---|---|
| Medicare Enrollment ID | O20130626000178 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396086211 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jude A Agendia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821287806 PECOS PAC ID: 0941380711 Enrollment ID: I20080107000198 |
Lake Charles Medical Services, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1717 Oak Park Blvd, Lake Charles, LA 70601 Phone: 337-582-7632 Fax: 337-582-7656 | |
Family Medical Center. Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2750 Aster St, Lake Charles, LA 70601 Phone: 337-478-2650 Fax: 337-478-8183 | |
Cardiovascular Outpatient Center Of Southwest Louisiana Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 401 Dr Michael Debakey Dr, Suite 300, Lake Charles, LA 70601 Phone: 337-602-9991 | |
Washington-marion Sbhc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2802 Pineview St, Lake Charles, LA 70615 Phone: 337-217-4540 Fax: 337-439-5029 | |
Headache And Wellness Center Of Southwest Louisiana, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 803 W Bayou Pines Dr Ste B, Lake Charles, LA 70601 Phone: 337-508-2333 | |
Imperial Health, Llp Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 501 Dr Michael Debakey Dr, Lake Charles, LA 70601 Phone: 337-433-8400 Fax: 337-312-6708 | |
Kndl Partners Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4200 Nelson Rd, Lake Charles, LA 70605 Phone: 337-475-4748 Fax: 337-944-4421 |