Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Northlake Primary Care

Organization Internal Medicine Physician · NPI 1063638831

Northlake Primary Care is an Internal Medicine Physician in Slidell, Louisiana. Licensed in Louisiana. Registered with an NPI since 2007.

Licensed in
LA
In the registry since
2007

Practice location Address checks out

951 Gause Blvd Ste 2
Slidell, LA 70458-2937
Phone: (985) 641-6454
Fax: (985) 641-6458
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence MD11789R (LA)

Record details

NPI number1063638831
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jose Lefran — Doctor · (985) 641-6454
NPI enumeratedApril 18, 2007
Last updated in NPPESAugust 22, 2020
Mailing address951 Gause Blvd Ste 2, Slidell, LA 70458-2937

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