Provider Demographics
NPI:1336381458
Name:CAO CARE INC
Entity Type:Organization
Organization Name:CAO CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MANDY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BROUDREAUX
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-734-7797
Mailing Address - Street 1:2924 KNIGHT ST STE 408
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-2413
Mailing Address - Country:US
Mailing Address - Phone:318-734-7797
Mailing Address - Fax:
Practice Address - Street 1:2924 KNIGHT ST STE 408
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-2413
Practice Address - Country:US
Practice Address - Phone:318-734-7797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-03
Last Update Date:2009-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA201161207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Multi-Specialty