Provider Demographics
NPI:1033397047
Name:ALETA N. DE CLOUET, M.D., LLC
Entity Type:Organization
Organization Name:ALETA N. DE CLOUET, M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALETA
Authorized Official - Middle Name:NATASHA
Authorized Official - Last Name:DECLOUET
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:985-781-7577
Mailing Address - Street 1:659 BROWNSWITCH ROAD
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-1233
Mailing Address - Country:US
Mailing Address - Phone:985-781-7577
Mailing Address - Fax:985-781-7579
Practice Address - Street 1:659 BROWNSWITCH ROAD
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-1233
Practice Address - Country:US
Practice Address - Phone:985-781-7577
Practice Address - Fax:985-781-7579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-01
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10807R261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
134322740OtherUNITED HEALTHCARE
134322740OtherCIGNA
134322740OtherGILSBAR
134322740OtherOFFICE OF GROUP BENEFITS
LA1534633Medicaid
134322740OtherCOVENTRY
134322740OtherHUMANA
LA436511262DOtherBLUE CROSS/BLUE SHIELD OF LA
134322740OtherTRICARE WPS
134322740OtherTRICARE
MS05933747Medicaid
134322740OtherAETNA
5DC89Medicare PIN
LA436511262DOtherBLUE CROSS/BLUE SHIELD OF LA