Provider Demographics
NPI:1275063703
Name:DR RENE J HYMEL DPM LLC
Entity Type:Organization
Organization Name:DR RENE J HYMEL DPM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RENE
Authorized Official - Middle Name:J
Authorized Official - Last Name:HYMEL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:985-796-2218
Mailing Address - Street 1:79225 LADY LN
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:LA
Mailing Address - Zip Code:70437-3115
Mailing Address - Country:US
Mailing Address - Phone:985-796-2218
Mailing Address - Fax:985-796-8667
Practice Address - Street 1:2101 ROBIN AVE STE 11
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-5773
Practice Address - Country:US
Practice Address - Phone:985-796-2218
Practice Address - Fax:985-796-8667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-18
Last Update Date:2017-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA303928213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2432729Medicaid