OrganizationActive
Gulf Coast Brain Sport & Spine LLC
NPI 1699055475 · Physical Medicine & Rehabilitation Physician · Covington, LA
Provider details
- NPI number
- 1699055475
- Entity type
- Organization
- Primary specialty
- Physical Medicine & Rehabilitation PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Beau Bagley, Owner(504) 237-1430
- License
- 14743R (LA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1331 Ochsner Blvd
Suite 100
Covington, LA 70433-8177
Phone: (985) 234-0490
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 2013
Mandeville, LA 70470-2013
Registry dates
- Enumerated
- 2011-08-24
- Last updated
- 2013-03-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.