Provider Demographics
NPI:1497753388
Name:MEAUX, RACHELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:RACHELLE
Middle Name:
Last Name:MEAUX
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:RACHELLE
Other - Middle Name:
Other - Last Name:MEAUX
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
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:337-216-0009
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:337-216-0009
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10636R207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1492043Medicaid
LA1492043Medicaid
LA5Y592DN11Medicare PIN