| Fayez K. Shamieh, M.d. A Medical Corporation | |
|
707 S Ryan St Lake Charles LA 70601-5728 | |
| (337) 433-0762 | |
| (337) 433-4868 |
| Full Name | Fayez K. Shamieh, M.d. A Medical Corporation |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 707 S Ryan St, Lake Charles, Louisiana |
| Authorized Official Name and Position | Fayez K Shamieh (PRESIDENT) |
| Authorized Official Contact | 3374330762 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fayez K. Shamieh, M.d. A Medical Corporation 707 S Ryan St Lake Charles LA 70601-5728 Ph: (337) 433-0762 | Fayez K. Shamieh, M.d. A Medical Corporation 707 S Ryan St Lake Charles LA 70601-5728 Ph: (337) 433-0762 |
| NPI Number | 1639379670 |
|---|---|
| Provider Enumeration Date | 07/18/2007 |
| Last Update Date | 08/19/2008 |
| Medicare PECOS PAC ID | 2961577317 |
|---|---|
| Medicare Enrollment ID | O20080819000601 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639379670 | NPI | - | NPPES |
| 1949973 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 15000 (Louisiana) | Primary |
| Provider Name | Fayez K Shamieh |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1861582504 PECOS PAC ID: 2062514722 Enrollment ID: I20070227000149 |
| Provider Name | Timothy R Best |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1245212455 PECOS PAC ID: 7214025964 Enrollment ID: I20090113000827 |
| Provider Name | Joyce J Poole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093928491 PECOS PAC ID: 5294983359 Enrollment ID: I20150616001567 |
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