Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 11924R | LA |
N | 207RC0000X | Internist - Cardiovascular Disease | 11924R | LA |
N | 207RI0011X | Interventional Cardiology | 11924R | LA |
NPI | 1437156429 |
---|---|
Provider Name | Peter Stevens Fail |
First Address | Houma, LA 70360-4440 |
Second Address | Houma, LA 70360 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2005 |
Last Update Date | 05/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
060042304 | RR MEDICARE (01) | LA |
1681784 | (05) | LA |
5Y0006833 | (02) | LA |
E98995 | (02) | LA |