Provider Demographics
NPI:1821323361
Name:FARHANA AMIR, MD
Entity Type:Organization
Organization Name:FARHANA AMIR, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN, OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FARHANA
Authorized Official - Middle Name:
Authorized Official - Last Name:AMIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-289-4533
Mailing Address - Street 1:501 W SAINT MARY BLVD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-4600
Mailing Address - Country:US
Mailing Address - Phone:337-289-4533
Mailing Address - Fax:337-289-4286
Practice Address - Street 1:501 W SAINT MARY BLVD
Practice Address - Street 2:SUITE 320
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-4600
Practice Address - Country:US
Practice Address - Phone:337-289-4533
Practice Address - Fax:337-289-4286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-15
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA203012207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1507563Medicaid
LA1356559751OtherDR'S NPI
LA1821323361OtherGROUP NPI
LA4M486Medicare PIN