Provider Demographics
NPI:1922284371
Name:LAFAYETTE HEALTH VENTURES INC
Entity Type:Organization
Organization Name:LAFAYETTE HEALTH VENTURES INC
Other - Org Name:MIKE MOUNIR MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUVAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-289-8978
Mailing Address - Street 1:PO BOX 53092
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70505-3092
Mailing Address - Country:US
Mailing Address - Phone:337-289-8978
Mailing Address - Fax:337-289-8970
Practice Address - Street 1:429 HEYMANN BLVD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2616
Practice Address - Country:US
Practice Address - Phone:337-233-6730
Practice Address - Fax:337-237-9057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-16
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.03758R207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty