Provider Demographics
NPI:1205028412
Name:LELEUX, PATRICK DALE JR (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:DALE
Last Name:LELEUX
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:1307 CROWLEY RAYNE HWY
Mailing Address - Street 2:STE E
Mailing Address - City:CROWLEY
Mailing Address - State:LA
Mailing Address - Zip Code:70526-8210
Mailing Address - Country:US
Mailing Address - Phone:337-210-4045
Mailing Address - Fax:337-210-4047
Practice Address - Street 1:1307 CROWLEY RAYNE HWY STE E
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:LA
Practice Address - Zip Code:70526
Practice Address - Country:US
Practice Address - Phone:337-210-4045
Practice Address - Fax:337-210-4047
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-11
Last Update Date:2022-03-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LAGETP.LSU.IM207R00000X
LAMD202105207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1090476Medicaid