NPIMap

C H Wilkinson Physician Network

Organization Active NPI Family Medicine Physician · Lake Charles, LA

NPI 1295987709 · NPPES record last updated Oct 15, 2008

Key facts

NPI
1295987709
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
C H WILKINSON PHYSICIAN NETWORK
Practice address
1736 W. Prien Lake Road
Lake Charles, LA 70601
Phone
(337) 478-5085
Fax
(337) 478-5086
NPI assigned
Oct 15, 2008
Organization subpart
No

Authorized official

Name
Donna J Mikulecky
Title
Ceo President
Phone
(713) 277-2208

Corporate family (same tax ID) 31

Organizations that report the same tax identification number in the National Provider Directory.

View all 31

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Christus Medical GRP (32 organizations share this tax ID)

Locations

3704 North Blvd
Ste D
Alexandria, LA 71301
Phone (318) 528-3200

5531 Masonic Dr
Alexandria, LA 71301

3311 Prescott Rd
Alexandria, LA 71301
Phone (318) 473-1711

3704 North Blvd
Alexandria, LA 71301
Phone (318) 448-8211

3311 Prescott Rd
Ste 317
Alexandria, LA 71301
Phone (318) 448-6554

2539 Viking Dr
Bossier City, LA 71111
Phone (318) 741-2920

401 Dr Michael Debakey Dr
Ste 100
Lake Charles, LA 70601
Phone (337) 436-6100

1611 Foster St
Lake Charles, LA 70601
Phone (337) 433-2783

711 Doctor Michael Debakey Dr
Ste 10
Lake Charles, LA 70601

1453 E Bert Kouns Industrial Loop
Ste 317
Shreveport, LA 71105

9220 Ellerbe Rd
Ste 700
Shreveport, LA 71106
Phone (318) 681-5282

1453 E Bert Kouns Industrial Loop
#319
Shreveport, LA 71105

1415 Santa Fe St
Corpus Christi, TX 78404
Phone (361) 861-9760

5802 Saratoga Blvd
Ste 130
Corpus Christi, TX 78414
Phone (361) 696-6200

3828 Hughes Ct
Ste 207
Dickinson, TX 77539
Phone (281) 337-1304

3103 Megan St
Eagle Pass, TX 78852
Phone (210) 223-7500

2060 Space Park Dr
Ste 412
Houston, TX 77058
Phone (281) 335-4095

18100 Houston Methodist Dr
Ste 280
Houston, TX 77058

1311 E General Cavazos Blvd
Ste 201
Kingsville, TX 78363
Phone (361) 595-2223

1406 College Dr
Ste 1
Texarkana, TX 75503

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Q00000X Yes

Addresses

Primary practice location

1736 W. Prien Lake Road
Lake Charles, LA 70601

Mailing address

1736 W. Prien Lake Road
Lake Charles, LA 70601
Phone (337) 478-5085

Other names

  • CHRISTUS Medical Group Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 15, 2008.

{
    "created_epoch": "1224028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224028800000",
    "number": "1295987709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1736 W. PRIEN LAKE ROAD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "70601",
            "telephone_number": "337-478-5085",
            "fax_number": "337-478-5086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1736 W. PRIEN LAKE ROAD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "70601",
            "telephone_number": "337-478-5085",
            "fax_number": "337-478-5086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C H WILKINSON PHYSICIAN NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-15",
        "last_updated": "2008-10-15",
        "status": "A",
        "authorized_official_last_name": "MIKULECKY",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO PRESIDENT",
        "authorized_official_telephone_number": "713-277-2208"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHRISTUS Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Charles, LA

All providers in Lake Charles, LA · Family Medicine Physician in Louisiana

Sources for this page

Verify at the official NPI Registry.