Express Care Diagnostics of Southwest la., Inc

Primary specialty

Mobile Radiology Clinic/CenterTaxonomy code 261QR0208X

Legal business name

EXPRESS CARE DIAGNOSTICS OF SOUTHWEST LA., INC

Practice address

110 Hugh Wallis Rd
Lafayette, LA 70508-2107

Phone

(337) 289-5456

Fax

(337) 289-0119

NPI assigned

Mar 15, 2006

Last updated

Nov 9, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Shelia Lauw

Title

Owner

Phone

(281) 346-0801

Specialties & licenses 1

Addresses

Other identifiers 3

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257724800000",
    "number": "1366411191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80735",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705980735",
            "telephone_number": "281-346-0801",
            "fax_number": "281-346-0802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HUGH WALLIS RD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705082107",
            "telephone_number": "337-289-5456",
            "fax_number": "337-289-0119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPRESS CARE DIAGNOSTICS OF SOUTHWEST LA., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-15",
        "last_updated": "2009-11-09",
        "status": "A",
        "authorized_official_last_name": "LAUW",
        "authorized_official_first_name": "SHELIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-346-0801",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1904571",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "630000386",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "43784",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.