Provider Demographics
NPI:1114043759
Name:RACHELLE MEAUX, MD, A PROFESSIONAL MEDICAL CORPORAATION
Entity Type:Organization
Organization Name:RACHELLE MEAUX, MD, A PROFESSIONAL MEDICAL CORPORAATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KELLI
Authorized Official - Middle Name:A
Authorized Official - Last Name:ORTEGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-216-0000
Mailing Address - Street 1:4540 AMBASSADOR CAFFERY PKWY
Mailing Address - Street 2:STE C220
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-6928
Mailing Address - Country:US
Mailing Address - Phone:337-216-0000
Mailing Address - Fax:337-216-0009
Practice Address - Street 1:4540 AMBASSADOR CAFFERY PKWY
Practice Address - Street 2:STE C220
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-6928
Practice Address - Country:US
Practice Address - Phone:337-216-0000
Practice Address - Fax:337-216-0009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10636R207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1492043Medicaid
LA5Y592Medicare ID - Type Unspecified
LA1492043Medicaid