GARY M. AGENA MD LLC
Ambulatory Health at Highway 21, Madisonville, LA

License number
Louisiana MD200946
Category
Ambulatory Health
Type
Health Service
Owner
Name: DR. GARY MICHAEL AGENA MD
Title: MD/OWNER
Phone: (985) 845-7121
Address
Address
393 Highway 21 SUITE 525, Madisonville, LA 70447
National Provider ID: 1699021410
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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GARY M. AGENA, M.D. LLC

Madisonville, LA  -  Covington, LA

Doing business as:
Gary M Agena MD
Registration:
Mar 14, 2012
Phone:
(985) 845-7121 (Phone)
Addresses:
393 Hwy 21 SUITE 525, Madisonville, LA 70447 (Physical)
C/O Gary Agena, Covington, LA 70433 (Mailing)
State ID:
40771643K
Business type:
Limited Liability Company
Member:
Gary Agena (Member), 420 Shady Vw Ln, Covington, LA 70433 (Physical)
Categories:
Gynecology & Obstetrics Physicians & Surgeons, Physicians & Surgeons

Ambulatory Health licenses in Louisiana


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