St. Luke'S Diagnostic Clinic of Lake Charles, L.L.C.

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

017896 Issued in LA

Legal business name

ST. LUKE'S DIAGNOSTIC CLINIC OF LAKE CHARLES, L.L.C.

Practice address

643 S Ryan St
Lake Charles, LA 70601-5726

Phone

(337) 439-2000

Fax

(337) 439-2025

NPI assigned

Jul 28, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Bryan P Barrilleaux, M.D.

Title

Owner

Phone

(337) 439-2000

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699789529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "643 S RYAN ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706015726",
            "telephone_number": "337-439-2000",
            "fax_number": "337-439-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "643 S RYAN ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706015726",
            "telephone_number": "337-439-2000",
            "fax_number": "337-439-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUKE'S DIAGNOSTIC CLINIC OF LAKE CHARLES, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BARRILLEAUX",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "337-439-2000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "LA",
            "license": "017896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Specialty Clinic/Center in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Medical Specialty Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.