Provider Demographics
NPI:1356370589
Name:BICE, TULSI NILA (MD)
Entity type:Individual
Prefix:DR
First Name:TULSI
Middle Name:NILA
Last Name:BICE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 82480
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70884-2480
Mailing Address - Country:US
Mailing Address - Phone:225-368-2300
Mailing Address - Fax:225-368-2280
Practice Address - Street 1:9118 BLUEBONNET CENTRE BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-2993
Practice Address - Country:US
Practice Address - Phone:225-368-2300
Practice Address - Fax:225-368-2280
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA25802208100000X
LA0258022081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1577928Medicaid
LA4F363CS42Medicare PIN
LA4F363Medicare ID - Type Unspecified
LAH91018Medicare UPIN