Doc 4 Kids

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

L#13448R Issued in LA

Legal business name

DOC 4 KIDS

Doing business as

Doc 4 Kids

Practice address

1270 Attakapas Dr Ste 401 K
Opelousas, LA 70570-6549

Phone

(337) 407-0084

Fax

(337) 407-0094

NPI assigned

Apr 12, 2007

Last updated

Aug 22, 2020By 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

Dr. Carmen Enid Koubicek, M.D.NPI 1992855282

Title

President

Phone

(337) 407-0084

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Doc 4 Kids Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Carmen Enid Koubicek, MD

  • Pediatrics Physician
  • Opelousas, LA
  • NPI 1992855282
  NPD (past) Authorized official

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902020019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1270 ATTAKAPAS DR STE 401 K",
            "city": "OPELOUSAS",
            "state": "LA",
            "postal_code": "705706549",
            "telephone_number": "337-407-0084",
            "fax_number": "337-407-0094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1270 ATTAKAPAS DR STE 401 K",
            "city": "OPELOUSAS",
            "state": "LA",
            "postal_code": "705706549",
            "telephone_number": "337-407-0084",
            "fax_number": "337-407-0094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOC 4 KIDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOUBICEK",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_middle_name": "ENID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "337-407-0084",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "LA",
            "license": "L#13448R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1992855282",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1565911",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MED LICENSE",
            "identifier": "L#13448R",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Doc 4 Kids",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Primary Care Clinic/Center in Opelousas, LA
• Providers in Opelousas, LA by specialty
• Primary Care 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.