Provider Demographics
NPI:1366613424
Name:WOMEN'S PRIMARY HEALTH CARE, INC.
Entity type:Organization
Organization Name:WOMEN'S PRIMARY HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:SARFRAZ
Authorized Official - Suffix:
Authorized Official - Credentials:M,D
Authorized Official - Phone:337-238-5081
Mailing Address - Street 1:1112 PORT ARTHUR TER
Mailing Address - Street 2:
Mailing Address - City:LEESVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71446-4636
Mailing Address - Country:US
Mailing Address - Phone:337-238-5081
Mailing Address - Fax:337-392-9523
Practice Address - Street 1:1112 PORT ARTHUR TER
Practice Address - Street 2:
Practice Address - City:LEESVILLE
Practice Address - State:LA
Practice Address - Zip Code:71446-4636
Practice Address - Country:US
Practice Address - Phone:337-238-5081
Practice Address - Fax:337-392-9523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-17
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12654R261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1548529Medicaid
LA1548529Medicaid
LA5E256CN86Medicare PIN