Provider Demographics
NPI:1275532673
Name:NORTH OAKS PEDIATRIC CLINIC, L.L.P.
Entity Type:Organization
Organization Name:NORTH OAKS PEDIATRIC CLINIC, L.L.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE & BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MONISTERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-542-4950
Mailing Address - Street 1:42440 PELICAN PROFESSIONAL PARK
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-2403
Mailing Address - Country:US
Mailing Address - Phone:985-542-4950
Mailing Address - Fax:985-542-6089
Practice Address - Street 1:42440 PELICAN PROFESSIONAL PARK
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-2403
Practice Address - Country:US
Practice Address - Phone:985-542-4950
Practice Address - Fax:985-542-6089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-18
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA013387208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1795895Medicaid