Provider Demographics
NPI:1255330353
Name:WEST, THREVIA (MD)
Entity Type:Individual
Prefix:
First Name:THREVIA
Middle Name:
Last Name:WEST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 ROBLEY DR APT 4108
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-5530
Mailing Address - Country:US
Mailing Address - Phone:202-717-2931
Mailing Address - Fax:
Practice Address - Street 1:4704 AMBASSADOR CAFFERY PKWY STE 301
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-6908
Practice Address - Country:US
Practice Address - Phone:337-443-6870
Practice Address - Fax:337-443-6899
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101235519207VM0101X
LA300711207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1028259OtherCIGNA
VA1427548OtherMAMSI
VA540793767OtherVHN
VA185232OtherANTHEM
VA325437OtherSOUTHERN HEALTH
VA540793767OtherPHCS
VA010196558Medicaid
VI10001823OtherSENTARA
VA10196558OtherVIRGINIA PREMIER
VA1153268OtherAETNA HMO
VA4503577OtherAETNA PPO
VA540793767014OtherTRICARE
LA2409395Medicaid
VA5657179OtherFIRST HEALTH
LA2409395Medicaid
VA010196558Medicaid