THE KIDNEY CLINIC LLC (NPI# 1760665129) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1760665129 |
Entity Type | Organization |
Organization Name | THE KIDNEY CLINIC LLC |
Practice Address |
333 Dr Michael Debakey Dr Suite 140 Lake Charles LA 70601-5887 |
Mailing Address |
Po Box 3230 Lake Charles LA 70602-3230 |
Practice Telephone | 3374947090 |
Practice Fax Number | 3374947040 |
Mailing Telephone | 3374947090 |
Mailing Fax Number | 3374947040 |
Enumeration Date | 2007-12-07 |
Last Update Date | 2009-12-07 |
Authorized Official Name | DR. ABDEL FARID ABU SHAMAT (MEMBER/PRESIDENT) |
Authorized Official Telephone | 3374947090 |
Authorized Official Credential | M.D |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
MD11617R | LA | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
LA | 1679232 | 05 |
Street Address |
333 DR MICHAEL DEBAKEY DR SUITE 140 |
City | LAKE CHARLES |
State | LA |
Zip Code | 70601-5887 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902807340 | Roberta A Dowden | Social Worker | 333 Dr Michael Debakey Dr, Ste, 220, Lake Charles, LA 70601-5887 | 2005-08-09 |
1801262902 | Erica Hessifer | Psychiatry & Neurology | 333 Dr Michael Debakey Dr, Suite 220, Lake Charles, LA 70601-5887 | 2015-08-12 |
1184972127 | Imperial Health, LLP | Family Medicine | 333 Dr Michael Debakey Dr, Ste 110, Lake Charles, LA 70601-5889 | 2012-08-23 |
1790079465 | Michelle Trahan Dyer | Nurse Practitioner | 333 Dr Michael Debakey Dr, Suite 220, Lake Charles, LA 70601-5888 | 2011-05-30 |
1982833851 | Ahad Aftab Khan Lodhi | Internal Medicine | 333 Dr Michael Debakey Dr, Suite 140, Lake Charles, LA 70601-5889 | 2009-07-13 |
1639379837 | Andres J Guillermo | Family Medicine | 333 Dr Michael Debakey Dr, Lake Charles, LA 70601-5887 | 2007-07-25 |
1942258363 | Michelle D Nguyen | Nurse Practitioner | 333 Dr Michael Debakey Dr, Lake Charles, LA 70601 | 2006-05-05 |
1174583249 | Michael L. Brown | Psychiatry & Neurology | 333 Dr Michael Debakey Dr, Suite 220, Lake Charles, LA 70601-5887 | 2006-03-24 |
1467434191 | Jayendra K Patel | Psychiatry & Neurology | 333 Dr Michael Debakey Dr, Ste. 220, Lake Charles, LA 70601-5887 | 2005-11-17 |
1528053824 | Abdel Farid Abu Shamat | Internal Medicine | 333 Dr Michael Debakey Dr, Suite 140, Lake Charles, LA 70601-5887 | 2005-09-13 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144833872 | Fresenius Medical Care Sulphur, LLC | Clinic/Center | 330 Chavanne Street, Lake Charles, LA 70601 | 2020-08-24 |
1174158844 | Andrea Cormier | Peer Specialist | 751 E Bayou Pines Drive, Suite C, Lake Charles, LA 70601 | 2020-03-03 |
1588297303 | Vivian Claire Miller Monceaux | Chiropractor | 780 Bayou Pines East Drive, Lake Charles, LA 70601 | 2020-02-20 |
1568001014 | Swla Center for Health Services | Clinic/Center | 3820 Senator J. Bennett Johnston Ave, Charleston Bldg 8, Lake Charles, LA 70601 | 2020-01-02 |
1417512070 | Ryan Nathaniel Vaisler | Student in an Organized Health Care Education/Training Program | 1525 Oak Park Blvd., Lake Charles, LA 70601 | 2019-05-08 |
1336600675 | Hoh Palliative Care, LLC | Family Medicine | 750 East Bayou Pines, Suite A, Lake Charles, LA 70601 | 2019-03-28 |
1073079026 | Alawrass LLC | Pharmacy | 803 E Prien Lake Rd, Lake Charles, LA 70601 | 2019-02-14 |
1861962722 | Ellaweena Woods | Counselor | 1409 Kirkman St., Lake Charles, LA 70601 | 2018-12-04 |
1770051963 | Hanna Marie Rodriguez | Counselor | 751 Bayou Pines Drive, Suite C, Lake Charles, LA 70601 | 2018-11-06 |
1023585213 | Shandora Druilhet | Case Manager/Care Coordinator | 751 E Bayou Pines, Lake Charles, LA 70601 | 2018-10-26 |
Find all providers in zip 70601 |
Taxonomy Code | 261QH0100X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Health Service |
Definition to come... |
Notes: [7/1/2006: modified title] |
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---|---|---|---|---|
1205137197 | Applegate Recovery Lake Charles | Clinic/Center | 617 W Prien Lake Rd, Ste: L, Lake Charles, LA 70601-8386 | 2010-11-08 |
1659569119 | Moss Bluff Chiropractic Clinic | Clinic/Center | 119 Tahoe Dr, Lake Charles, LA 70611-5109 | 2007-10-10 |
1154456507 | Health Associates of Lake Charles | Clinic/Center | 2800 1st Ave Ste A, Lake Charles, LA 70601-8884 | 2007-02-23 |
1720008675 | Minor Medical Clinic LLC | Clinic/Center | 109 Executive Dr., Suite C, Lake Charles, LA 70611-5328 | 2006-07-20 |
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1922591080 | Aca Clinic | Clinic/Center | 23823 Eden St, Plaquemine, LA 70764-3315 | 2018-06-12 |
1841794989 | West Wellness, LLC | Clinic/Center | 7941 Picardy Ave Ofc 2, Baton Rouge, LA 70809-3536 | 2018-03-22 |
1588195341 | Ann M Waguespack | Clinic/Center | 9736 Kinglet Dr, Baton Rouge, LA 70809-4611 | 2017-03-23 |
1104297720 | Southern Pediatric Clinic | Clinic/Center | 202 N Thomas Dr, Suite 1, Shreveport, LA 71107-6539 | 2015-10-08 |
1619355955 | Heavenly Touch Personal Care | Clinic/Center | 235 Olive St, Shreveport, LA 71104-2415 | 2015-05-07 |
1396135331 | Affinity Medical Center | Clinic/Center | 3143 N Roman St, New Orleans, LA 70117-6509 | 2015-01-29 |
1689081218 | Mps Healthcare, LLC | Clinic/Center | 16416 Spanish Ct, Greenwell Springs, LA 70739-5936 | 2014-07-15 |
1578821948 | Dyson & Dyson Inc. | Clinic/Center | 322 Messina St., Abbeville, LA 70510 | 2012-04-24 |
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City | LAKE CHARLES |
Zip Code | 70601 |
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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.