Provider Demographics
NPI:1154574267
Name:LOUISIANA HEART CLINIC,INC
Entity type:Organization
Organization Name:LOUISIANA HEART CLINIC,INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:USMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD,FACC
Authorized Official - Phone:337-942-5750
Mailing Address - Street 1:PO BOX 52844
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70505-2844
Mailing Address - Country:US
Mailing Address - Phone:337-942-5750
Mailing Address - Fax:337-948-9405
Practice Address - Street 1:611 E PRUDHOMME ST
Practice Address - Street 2:SUITE 3
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570-6458
Practice Address - Country:US
Practice Address - Phone:337-942-5750
Practice Address - Fax:337-948-9405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-03
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12747R207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAG94926Medicare UPIN