Provider Demographics
NPI:1962536193
Name:SURGICAL WEIGHT MANAGEMENT ASSOCIATES, LLC
Entity type:Organization
Organization Name:SURGICAL WEIGHT MANAGEMENT ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:H
Authorized Official - Last Name:RAU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:985-868-2206
Mailing Address - Street 1:5619 HIGHWAY 311
Mailing Address - Street 2:SUITE B
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-5595
Mailing Address - Country:US
Mailing Address - Phone:985-868-2206
Mailing Address - Fax:985-868-2232
Practice Address - Street 1:5619 HIGHWAY 311
Practice Address - Street 2:SUITE B
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-5595
Practice Address - Country:US
Practice Address - Phone:985-868-2206
Practice Address - Fax:985-868-2232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAOC16113174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty