Provider Demographics
NPI:1598084725
Name:DORVAL SURGICAL LLC
Entity Type:Organization
Organization Name:DORVAL SURGICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:BAPTISTE
Authorized Official - Last Name:DORVAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:940-642-3059
Mailing Address - Street 1:151 HILL ST
Mailing Address - Street 2:
Mailing Address - City:EUNICE
Mailing Address - State:LA
Mailing Address - Zip Code:70535-5845
Mailing Address - Country:US
Mailing Address - Phone:337-457-8061
Mailing Address - Fax:337-457-4392
Practice Address - Street 1:151 HILL ST
Practice Address - Street 2:
Practice Address - City:EUNICE
Practice Address - State:LA
Practice Address - Zip Code:70535-5845
Practice Address - Country:US
Practice Address - Phone:337-457-8061
Practice Address - Fax:337-457-4392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-27
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD 203520261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical