Davalos, Fidencio Hernan

Davalos, Fidencio Hernan is an sole proprietor health care provider with primary practice located at 2770 3Rd Ave Ste 350 , Lake Charles LA 70601-0404. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Critical Care Medicine. Allopathic & Osteopathic Physicians / Critical Care Medicine is his primary health care specialty. Davalos, Fidencio Hernan can be contacted via phone (337) 494-2750.

Contact Information

Primary practice address
2770 3Rd Ave Ste 350 Lake Charles LA 70601-0404
Phone: (337) 494-2750
Fax: (337) 494-2760
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD2017-0687 New Mexico
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X 322076 Louisiana
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X 287474 New York

Profile Details

NPI number 1265872725
LBN Legal business name Davalos, Fidencio Hernan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 28th, 2013
Last updated Mar 16th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265872725 NPPES
Louisiana MEDICAID 2528696
Louisiana Other MD.322076

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