Provider Demographics
NPI:1316044720
Name:LOUISIANA CARDIAC IMAGING
Entity Type:Organization
Organization Name:LOUISIANA CARDIAC IMAGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:IMRAN
Authorized Official - Middle Name:I
Authorized Official - Last Name:CHAUDRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-728-9486
Mailing Address - Street 1:HIGHWAY 250 3048
Mailing Address - Street 2:PO BOX 329
Mailing Address - City:RAYVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71269
Mailing Address - Country:US
Mailing Address - Phone:318-728-9864
Mailing Address - Fax:
Practice Address - Street 1:LOUISIANA CARDIAC IMAGING
Practice Address - Street 2:HIGHWAY 250 3048
Practice Address - City:RAYVILLE
Practice Address - State:LA
Practice Address - Zip Code:71269
Practice Address - Country:US
Practice Address - Phone:318-728-9864
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Not Answered2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5DA02Medicare ID - Type Unspecified