COLONNADE ENDOSCOPY CENTER LLC NPI 1184605792

NPI Information

COLONNADE ENDOSCOPY CENTER LLC is an endoscopy clinic center in Lake Charles, LA. COLONNADE ENDOSCOPY CENTER LLC NPI is 1184605792. The provider is registered as an organization entity type.

The provider's business location address is:

555 DR MICHAEL DEBAKEY DR STE 102
LAKE CHARLES, LA
ZIP 70601
Phone: (337) 439-6226
Fax: (337) 436-8862

The provider's authorized official is Sabra Brown Moore .
The authorized official title is Administrator and has the following contact phone number (337) 439-6226.

The CLIA number assigned to this NPI record is 19D2087065 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/10/2005 and was last updated on 6/28/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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