Provider Demographics
NPI:1154856383
Name:COURVILLE FAMILY HEALTH, LLC
Entity Type:Organization
Organization Name:COURVILLE FAMILY HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:JERRY
Authorized Official - Last Name:COURVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-485-8186
Mailing Address - Street 1:PO BOX 280
Mailing Address - Street 2:
Mailing Address - City:KINDER
Mailing Address - State:LA
Mailing Address - Zip Code:70648-0280
Mailing Address - Country:US
Mailing Address - Phone:337-738-2713
Mailing Address - Fax:
Practice Address - Street 1:208 6TH AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:KINDER
Practice Address - State:LA
Practice Address - Zip Code:70648-3186
Practice Address - Country:US
Practice Address - Phone:337-738-2713
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-25
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.208086261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center