Family Medicine
EXECUTIVE MEDICAL CLINIC OF LAKE CHARLES
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1982126520 · enumerated 2017-07-14 · record updated 2022-09-19. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Authorized official: MELISSA LEBRUN DNP, President · (225) 939-0050
Addresses and phones
- Practice location 765 EAST BAYOU PINES DRIVE, LAKE CHARLES, LA, 70601-5690 (337) 210-1260 Google Maps Apple Maps OpenStreetMap
- Mailing address 765 EAST BAYOU PINES DRIVE, LAKE CHARLES, LA, 70601-5690 (337) 210-1260 Google Maps Apple Maps OpenStreetMap
Specialties
- Family Medicine 207Q00000X · Primary · License AP06496 LA
In this directory
Locations and evidence
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Practice location
LAKE CHARLES, LA, 706015690
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.