Provider Demographics
NPI:1073620498
Name:CHILDREN'S INTERNATIONAL L.L.C.
Entity Type:Organization
Organization Name:CHILDREN'S INTERNATIONAL L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:J
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:985-781-7337
Mailing Address - Street 1:1430 LINDBERG DR
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-8056
Mailing Address - Country:US
Mailing Address - Phone:985-781-7337
Mailing Address - Fax:985-781-7339
Practice Address - Street 1:1430 LINDBERG DR
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-8056
Practice Address - Country:US
Practice Address - Phone:985-781-7337
Practice Address - Fax:985-781-7339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1449334Medicaid
MS09015381Medicaid