Provider Demographics
NPI:1124828652
Name:CATH LAB AMBULATORY CENTER CARDIOLOGY SPECIALIST OF ACADIANA, LLC
Entity type:Organization
Organization Name:CATH LAB AMBULATORY CENTER CARDIOLOGY SPECIALIST OF ACADIANA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BOBBY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROUSE
Authorized Official - Suffix:
Authorized Official - Credentials:CFO
Authorized Official - Phone:901-219-8656
Mailing Address - Street 1:309 RUE LOUIS XIV
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508
Mailing Address - Country:US
Mailing Address - Phone:337-269-9777
Mailing Address - Fax:337-269-0244
Practice Address - Street 1:309 RUE LOUIS XIV
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-7050
Practice Address - Country:US
Practice Address - Phone:337-269-9777
Practice Address - Fax:337-269-0244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical