TECHE ACTION BOARD, INC. (NPI# 1659319135) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1659319135 |
Entity Type | Organization |
Organization Name | TECHE ACTION BOARD, INC. |
Other Organization Name | TECHE ACTION CLINIC @ DULAC |
Practice Address |
189 Mozart Dr Houma LA 70363-7990 |
Mailing Address |
1115 Weber Street Franklin LA 70538-4124 |
Practice Telephone | 9858683700 |
Practice Fax Number | 9858683704 |
Mailing Telephone | 3378282550 |
Mailing Fax Number | 3373552335 |
Enumeration Date | 2006-06-04 |
Last Update Date | 2016-07-20 |
Authorized Official Name | DR. GARY M WILTZ (CHIEF EXECUTIVE OFFICER) |
Authorized Official Telephone | 3378282550 |
Authorized Official Credential | M.D. |
Is Organization Subpart | Y |
Parent Organization Name | TECHE ACTION BOARD, INC. |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
LA | 2134426 | 05 |
Other Name | Type Code |
---|---|
TECHE ACTION CLINIC @ DULAC | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912354176 | Teche Action Board, Inc. | Clinic/Center | 2555 La Hwy 18, Edgard, LA 70049-2417 | 2016-05-18 |
1215354014 | Teche Action Board, Inc. | Clinic/Center | 121 West 134th Place, Galliano, LA 70354 | 2014-03-19 |
1902082811 | Teche Action Board, Inc. | Clinic/Center | 18331 Highway 182, Baldwin, LA 70514-1449 | 2008-01-10 |
1154368553 | Teche Action Board, Inc. | Clinic/Center | 159 E 3rd St, Edgard, LA 70049-2450 | 2006-06-02 |
1215974019 | Teche Action Board, Inc. | Clinic/Center | 1014 West Tunnel Blvd, Houma, LA 70360-5555 | 2006-06-01 |
1760016562 | Teche Action Board, Inc. | Pharmacist | 1124 7th St, Morgan City, LA 70380 | 2020-03-02 |
1639702087 | Teche Action Board, Inc. | Pharmacy | 1124 7th St, Morgan City, LA 70380-1951 | 2020-02-13 |
1801433883 | Teche Action Board, Inc. | Clinic/Center | 827 N Pine St, Gramercy, LA 70052-3602 | 2019-12-09 |
1255788428 | Teche Action Board, Inc. | Clinic/Center | 1 Wildcat Dr, Reserve, LA 70084-5800 | 2016-05-18 |
1477900637 | Teche Action Board, Inc. | Clinic/Center | 393 Greenwood Dr, La Place, LA 70068-2535 | 2016-05-18 |
Street Address |
189 MOZART DR |
City | HOUMA |
State | LA |
Zip Code | 70363-7990 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992743892 | Stacey B Molinere | Nurse Practitioner | 189 Mozart Dr, Houma, LA 70363-7990 | 2006-06-03 |
1700254604 | Shannon Huertas | Counselor | 189 Mozart Dr, Houma, LA 70363-7990 | 2015-09-09 |
1164741799 | Melissa W Clay | Nurse Practitioner | 189 Mozart Dr, Houma, LA 70363-7990 | 2010-05-21 |
1962434910 | Rhonesia Simmons | Internal Medicine | 189 Mozart Dr, Houma, LA 70363-7990 | 2006-07-07 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588286991 | Nadish Ravindran | Student in an Organized Health Care Education/Training Program | 1978 Industrial Blvd Internal Medicine Program, Chabert Medical Center, Houma, LA 70363 | 2020-05-08 |
1912527185 | Gurjit Singh Brar | Student in an Organized Health Care Education/Training Program | Chabert Medical Center 1978 Industrial Blvd, Internal Medicine Residency Program, Houma, LA 70363 | 2020-04-17 |
1912568718 | Blake P Pitre | Pharmacist | 13087 West Main St, Larose, LA 70363 | 2019-06-24 |
1528623212 | Navkiran Singh Jagdev | Student in an Organized Health Care Education/Training Program | 1978 Industrial Blvd Chabert Medical Center, Internal Medicine Residency Program, Houma, LA 70363 | 2019-05-08 |
1376107367 | Sheahahn Vikash Soundranayagam | Student in an Organized Health Care Education/Training Program | Internal Medicine Residency Program Chabert Medical, Center, 1978 Industrial Blvd, Hourna, LA 70363 | 2019-04-25 |
1962991034 | Naveen Silva | Student in an Organized Health Care Education/Training Program | 1976 Industrial Blvd, Internal Medicine Residency Program Chabert Medical Cen, Houma, LA 70363 | 2018-05-04 |
1841647526 | Ammad Asad Syed | Student in an Organized Health Care Education/Training Program | 1978 Industrial Blvd., Internal Medicine Residency Program, Chabert Medical Ce, Houma, LA 70363 | 2016-05-23 |
1538514450 | Khizran Rizvi | Internal Medicine | 1978 Industrial Blvd. Chabert Medical Center, Internal Medicine Residency Program, Houma, LA 70363 | 2016-04-28 |
1649656836 | David Price | Pharmacist | 9303 East Parke Avenue, Houma, LA 70363 | 2015-08-11 |
1346638053 | Donna Marie Neville | Case Manager/Care Coordinator | 137 New Orleans Blvd, Houma, LA 70363 | 2015-01-05 |
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Taxonomy Code | 261QF0400X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Federally Qualified Health Center (FQHC) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1699382697 | Start Corporation | Clinic/Center | 106 School Street, Houma, LA 70360 | 2020-09-24 |
1215974019 | Teche Action Board, Inc. | Clinic/Center | 1014 West Tunnel Blvd, Houma, LA 70360-5555 | 2006-06-01 |
1831692540 | Start Corporation | Clinic/Center | 235 Civic Center Blvd, Houma, LA 70360-5937 | 2018-03-09 |
1902260136 | Start Corporation | Clinic/Center | 420 Magnolia St, Houma, LA 70360-6304 | 2016-04-13 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.