Provider Demographics
NPI:1134173180
Name:HOOVER, BENDEL CARROL (DPM)
Entity type:Individual
Prefix:DR
First Name:BENDEL
Middle Name:CARROL
Last Name:HOOVER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1799 STUMPF BLVD
Mailing Address - Street 2:BUILDING 2 SUITE 5
Mailing Address - City:TERRYTOWN
Mailing Address - State:LA
Mailing Address - Zip Code:70056-3950
Mailing Address - Country:US
Mailing Address - Phone:504-362-3720
Mailing Address - Fax:504-368-6422
Practice Address - Street 1:1799 STUMPF BLVD
Practice Address - Street 2:BUILDING 2 SUITE 5
Practice Address - City:TERRYTOWN
Practice Address - State:LA
Practice Address - Zip Code:70056-3950
Practice Address - Country:US
Practice Address - Phone:504-362-3720
Practice Address - Fax:504-368-6422
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-22
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPD058R213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1384461Medicaid
LA1384461Medicaid
LA56592Medicare ID - Type Unspecified