| Carlock Enterprises Llc | |
|
2778 Hwy 121 Suite A Otis LA 71466-0000 | |
| (318) 793-5020 | |
| (318) 759-0828 |
| Full Name | Carlock Enterprises Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2778 Hwy 121, Otis, Louisiana |
| Authorized Official Name and Position | Victor Carlock (FNP/OWNER) |
| Authorized Official Contact | 3184195188 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carlock Enterprises Llc 2778 Hwy 121 Suite A Otis LA 71466-0000 Ph: (318) 793-5020 | Carlock Enterprises Llc 2778 Hwy 121 Suite A Otis LA 71466-0000 Ph: (318) 793-5020 |
| NPI Number | 1437506474 |
|---|---|
| Provider Enumeration Date | 05/19/2016 |
| Last Update Date | 07/28/2025 |
| Medicare PECOS PAC ID | 3476707514 |
|---|---|
| Medicare Enrollment ID | O20180925002091 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437506474 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |