Provider Demographics
NPI:1033343793
Name:DR.EDUARDO CHAMAH OFICINA MEDICA , C.S.P.
Entity Type:Organization
Organization Name:DR.EDUARDO CHAMAH OFICINA MEDICA , C.S.P.
Other - Org Name:DR EDUARDO CHAMAH OFICINA MEDICA, C.S.P.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHAMAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-806-0293
Mailing Address - Street 1:1042 CAMELLIA BLVD APT 3412
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-6692
Mailing Address - Country:US
Mailing Address - Phone:337-806-0293
Mailing Address - Fax:
Practice Address - Street 1:1042 CAMELLIA BLVD APT 3412
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-6692
Practice Address - Country:US
Practice Address - Phone:337-806-0293
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-11
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261Q00000X
PR10266261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service