Provider Demographics
NPI:1033579701
Name:NATIONAL MEDICAL PROFESSIONALS OF LOUISIANA PROFESSIONAL LLC
Entity Type:Organization
Organization Name:NATIONAL MEDICAL PROFESSIONALS OF LOUISIANA PROFESSIONAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:LYLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-899-6666
Mailing Address - Street 1:220 LAS COLINAS BLVD E
Mailing Address - Street 2:STE 1000
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-5503
Mailing Address - Country:US
Mailing Address - Phone:972-899-6666
Mailing Address - Fax:
Practice Address - Street 1:220 LAS COLINAS BLVD E
Practice Address - Street 2:STE 1000
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-5503
Practice Address - Country:US
Practice Address - Phone:972-899-6666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-24
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty