Provider Demographics
NPI:1962474759
Name:RED RIVER CARDIAC IMAGING, LLC
Entity Type:Organization
Organization Name:RED RIVER CARDIAC IMAGING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALAA
Authorized Official - Middle Name:H
Authorized Official - Last Name:YOUNES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-767-2131
Mailing Address - Street 1:3311 PRESCOTT RD
Mailing Address - Street 2:SUITE 116
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-3900
Mailing Address - Country:US
Mailing Address - Phone:318-767-2131
Mailing Address - Fax:318-767-2159
Practice Address - Street 1:3311 PRESCOTT RD
Practice Address - Street 2:SUITE 116
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-3900
Practice Address - Country:US
Practice Address - Phone:318-767-2131
Practice Address - Fax:318-767-2159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1447765Medicaid
LA5CP21Medicare ID - Type Unspecified