Provider Demographics
NPI:1073839668
Name:RACHELLE MEAUX, MD A PROFESSIONAL MEDICAL CORPORATION
Entity Type:Organization
Organization Name:RACHELLE MEAUX, MD A PROFESSIONAL MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MEAUX
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-216-0000
Mailing Address - Street 1:200 BEAULLIEU DR
Mailing Address - Street 2:BLDG. # 4
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-7226
Mailing Address - Country:US
Mailing Address - Phone:337-216-0000
Mailing Address - Fax:317-216-0009
Practice Address - Street 1:200 BEAULLIEU DR
Practice Address - Street 2:BLDG. # 4
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-7226
Practice Address - Country:US
Practice Address - Phone:337-216-0000
Practice Address - Fax:317-216-0009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-08
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5DN11Medicare PIN