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Contact Information

MAGNIFICENT MINDS TELEMED
630 W CORNERVIEW ST STE B
GONZALES, LA70737-2742
 Phone: 225-647-4105
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Child & Adolescent Psychiatry

2084P0804X 86 Physician/Neuropsychiatry
 

Psychiatric/Mental Health

363LP0808X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for MAGNIFICENT MINDS TELEMED

NPI # 1275255309
LBN Legal business name MAGNIFICENT MINDS TELEMED
Authorized official DEMARCUS PATTERSON - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 09/15/2022
Last updated 09/15/2022 - About 4 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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