Provider Demographics
NPI:1871637850
Name:REHABILITATION AND RHEUMATOLOGY ASSOCIATES, LLC
Entity Type:Organization
Organization Name:REHABILITATION AND RHEUMATOLOGY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-475-7598
Mailing Address - Street 1:PO BOX 3084
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70602-3084
Mailing Address - Country:US
Mailing Address - Phone:337-436-7560
Mailing Address - Fax:337-433-9861
Practice Address - Street 1:1920 W SALE RD
Practice Address - Street 2:BLDG F-3
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-2400
Practice Address - Country:US
Practice Address - Phone:337-475-7598
Practice Address - Fax:337-475-2814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9855R208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAC29819Medicare UPIN