Provider Demographics
NPI:1952175770
Name:ACCESS PRIMARY CARE LLC
Entity type:Organization
Organization Name:ACCESS PRIMARY CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:BERNAUER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:337-312-6070
Mailing Address - Street 1:1530 E MCNEESE ST STE 1
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70607-4784
Mailing Address - Country:US
Mailing Address - Phone:337-312-6070
Mailing Address - Fax:
Practice Address - Street 1:1530 E MCNEESE ST STE 1
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70607-4784
Practice Address - Country:US
Practice Address - Phone:337-312-6070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-13
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty