Organization

Pediatric Clinic Westbank

Pediatrics Physician in Gretna, LA(View on Map)

Legal Business Name

Pediatric Clinic Westbank

NPI Number

1003904236

NPI Type

Organization

Enumeration Date

10/11/2006

Specialties

(Taxonomies)

Code

208000000X

Primary Taxonomy

Yes

Licenses

State

Louisiana

License Number

018557

Contact
Information

Purpose

Mailing
Location

Address

151 MEADOWCREST ST STE F
151 MEADOWCREST ST STE F

City

Gretna
Gretna

State

LA
LA

Postal Code

70056-5256
70056-5256

Country

US
US

Telephone Number

(504) 392-9298
(504) 392-9298

Authorized Official

Name

Mrs. Tammy Grafe

Title or Position

OFFICE MANAGER

Telephone Number

(504) 392-9298

Identifiers

Identifier

1945242

Identifier State

LA

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 05/20/2010

Provider Address

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