Provider Demographics
NPI:1033142807
Name:ALEXANDRIA CARDIOLOGY CLINIC
Entity Type:Organization
Organization Name:ALEXANDRIA CARDIOLOGY CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT SENIOR PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PARAMESWARA
Authorized Official - Middle Name:KRISHNA
Authorized Official - Last Name:KAIMAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-473-4613
Mailing Address - Street 1:211 4TH ST # 30115
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-8421
Mailing Address - Country:US
Mailing Address - Phone:318-473-4613
Mailing Address - Fax:318-443-3400
Practice Address - Street 1:501 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 250
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-8124
Practice Address - Country:US
Practice Address - Phone:318-473-4613
Practice Address - Fax:318-443-3400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS09015977Medicaid
LA1797065Medicaid
LACN9331OtherRAILROAD MEDICARE GROUP
LA1797065Medicaid