SECOND AVENUE MRI LLC NPI 1629174339

NPI Information

  • NPI: 1629174339
  • Provider Name: SECOND AVENUE MRI LLC
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Organization
  • Doing Business As: ADVANCED MRI
  • Address: 2770 3RD AVE
    SUITE 125
    LAKE CHARLES, LA
    ZIP 70601
  • Phone: (337) 494-2674

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NPI Details

SECOND AVENUE MRI LLC is a diagnostic radiology radiology in Lake Charles, LA. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. SECOND AVENUE MRI LLC NPI is 1629174339. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Advanced Mri.

The provider's business location address is:

2770 3RD AVE
SUITE 125
LAKE CHARLES, LA
ZIP 70601-994
Phone: (337) 494-2674
Fax: (337) 494-2694

The provider's authorized official is Richard Martinez .
The authorized official title is President and has the following contact phone number (337) 494-2674.

The enumeration date for this NPI number is 9/16/2006 and was last updated on 2/13/2014.

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085R0202XRadiologyDiagnostic RadiologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
15CS90MEDICARE PINLOUISIANA
21448001MEDICAIDLOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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