Provider Demographics
NPI:1881989424
Name:MICHEL, VICTOR THOMAS (RPH)
Entity type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:THOMAS
Last Name:MICHEL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1727 MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:T-1450
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-2409
Mailing Address - Country:US
Mailing Address - Phone:985-857-8620
Mailing Address - Fax:985-857-8620
Practice Address - Street 1:1727 MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:T-1450
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-2409
Practice Address - Country:US
Practice Address - Phone:985-857-8620
Practice Address - Fax:985-857-8620
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-11
Last Update Date:2011-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10038183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist