Provider Demographics
NPI:1356778039
Name:HEALTHY SOLUTIONS CLINIC OF CROWLEY
Entity type:Organization
Organization Name:HEALTHY SOLUTIONS CLINIC OF CROWLEY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DE LA NUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-783-2410
Mailing Address - Street 1:136 TOWER RD
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:LA
Mailing Address - Zip Code:70526-2211
Mailing Address - Country:US
Mailing Address - Phone:337-783-2410
Mailing Address - Fax:337-783-2412
Practice Address - Street 1:136 TOWER RD
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:LA
Practice Address - Zip Code:70526-2211
Practice Address - Country:US
Practice Address - Phone:337-783-2410
Practice Address - Fax:337-783-2412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-26
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD. 12971R207VB0002X
LAMD. 12939R207VB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VB0002XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObesity MedicineGroup - Single Specialty