Christus Health Central Louisiana
Organization Active NPI Dental Clinic/Center · Coushatta, LA
NPI 1790767267 · NPPES record last updated Oct 20, 2022
Key facts
- NPI
- 1790767267
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dental Clinic/Center 261QD0000X
- License
- 551RHC-1 (LA)
- Legal business name
- CHRISTUS HEALTH CENTRAL LOUISIANA
- Practice address
- 1401 Industrial Dr
Coushatta, LA 71019 - Phone
- (318) 932-2100
- Fax
- (318) 932-2010
- NPI assigned
- Nov 18, 2005
- Organization subpart
- No
Authorized official
- Name
- Monte Wilson
- Title
- Ceo
- Phone
- (337) 470-2100
Corporate family (same tax ID) 10
Practitioners 1
-
Daniel Edward Rose, DDS
National Provider Directory
- Tax ID family
- St Frances Cabrini
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | 551RHC-1 | LA | Yes |
Addresses
Primary practice location
1401 Industrial Dr
Coushatta, LA 71019
Mailing address
PO Box 847329
Dallas, TX 75284-7329
Phone (800) 756-7999
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1880795 | Medicaid | LA |
Other names
- CHRISTUS Coushatta Dental Clinic
Other providers in Coushatta, LA
- Christus Health Central Louisiana
- Christus Health Central Louisiana
- Christus Health Central Louisiana
- Christus Health Central Louisiana
- Christus Health Central Louisiana
- Christus Health Central Louisiana
- CLD Inc
- Thomas William Coleman
- Wyche Taylor Coleman Jr.
- Laura Elizabeth Colvin
All providers in Coushatta, LA · Dental Clinic/Center in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 20, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.