Provider Demographics
NPI:1457676132
Name:CARDIOMED CLINIC LLC
Entity Type:Organization
Organization Name:CARDIOMED CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:UMESH
Authorized Official - Middle Name:A
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:985-882-8488
Mailing Address - Street 1:64040 HIGHWAY 434
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LACOMBE
Mailing Address - State:LA
Mailing Address - Zip Code:70445-3499
Mailing Address - Country:US
Mailing Address - Phone:985-882-8488
Mailing Address - Fax:985-882-8487
Practice Address - Street 1:64040 HIGHWAY 434
Practice Address - Street 2:SUITE 101
Practice Address - City:LACOMBE
Practice Address - State:LA
Practice Address - Zip Code:70445-3499
Practice Address - Country:US
Practice Address - Phone:985-882-8488
Practice Address - Fax:985-882-8487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-06
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty