Provider Demographics
NPI:1114178639
Name:PATRICK DALE LELEUX JR MD LLC
Entity Type:Organization
Organization Name:PATRICK DALE LELEUX JR MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:LELEUX
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:337-643-1655
Mailing Address - Street 1:PO BOX 1348
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:LA
Mailing Address - Zip Code:70527
Mailing Address - Country:US
Mailing Address - Phone:337-643-1655
Mailing Address - Fax:337-643-1654
Practice Address - Street 1:202 N. JACKSON
Practice Address - Street 2:
Practice Address - City:KAPLAN
Practice Address - State:LA
Practice Address - Zip Code:70548
Practice Address - Country:US
Practice Address - Phone:337-643-1655
Practice Address - Fax:337-643-1654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-02
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD202105174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty