Provider Demographics
NPI:1548300866
Name:HEART CENTER OF ACADIANA
Entity type:Organization
Organization Name:HEART CENTER OF ACADIANA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SYED
Authorized Official - Middle Name:
Authorized Official - Last Name:FAZAL-UR-REHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:337-291-9410
Mailing Address - Street 1:PO BOX 53628
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70505-3628
Mailing Address - Country:US
Mailing Address - Phone:337-291-9410
Mailing Address - Fax:337-593-8310
Practice Address - Street 1:4906 AMBASSADOR CAFFERY PKWY
Practice Address - Street 2:N SUITE 1400
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-6965
Practice Address - Country:US
Practice Address - Phone:337-988-9003
Practice Address - Fax:337-988-9921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12136R207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty