| Organization Name: | GONZALES ENDOSCOPY CENTER LLC |
| NPI Number: | 1013178417 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BOGDAN NOWAKOWSKI (MEDICAL DIRECTOR) |
| Mailing Address: | 1433 E Highway 30 Gonzales |
| State: | LA US |
| Postal Code: | 707374765 |
| Phone Number: | 2256476900 |
| Fax Number: | 2256441453 |
| NPI Enumeration Date: | 06/19/2008 |
| NPI Last Update Date: | 06/19/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QE0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Endoscopy |
| Taxonomy Definition: | |