1316237647 NPI number — SARA LAGRAND ARGUELLO MD, MPHTM

Table of content: SARA LAGRAND ARGUELLO MD, MPHTM (NPI 1316237647)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316237647 NPI number — SARA LAGRAND ARGUELLO MD, MPHTM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ARGUELLO
Provider First Name:
SARA
Provider Middle Name:
LAGRAND
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD, MPHTM
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316237647
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/27/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3436 MAGAZINE ST # 310
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW ORLEANS
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70115-2413
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
505-270-8641
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2601 TULANE AVE SUITE 500
Provider Second Line Business Practice Location Address:
CRESCENTCARE
Provider Business Practice Location Address City Name:
NEW ORLEANS
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70119
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-821-2601
Provider Business Practice Location Address Fax Number:
504-267-3014
Provider Enumeration Date:
04/07/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RI0200X , with the licence number:  206934 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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