Provider Demographics
NPI:1437370335
Name:HOUMA HEALTH CLINIC, INC
Entity Type:Organization
Organization Name:HOUMA HEALTH CLINIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:DECOURCY
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:985-853-2343
Mailing Address - Street 1:827 BAYOU GARDENS BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70364-1464
Mailing Address - Country:US
Mailing Address - Phone:985-853-2343
Mailing Address - Fax:985-853-0589
Practice Address - Street 1:827 BAYOU GARDENS BLVD
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70364-1464
Practice Address - Country:US
Practice Address - Phone:985-853-2343
Practice Address - Fax:985-853-0589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA14187R207R00000X
LA40568-4796363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1448842Medicaid
LA5CB56Medicare PIN