Provider Demographics
NPI:1700845773
Name:TRAHAN, DONALD E (PT)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:E
Last Name:TRAHAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 158
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70592-0158
Mailing Address - Country:US
Mailing Address - Phone:337-856-1717
Mailing Address - Fax:337-856-1818
Practice Address - Street 1:327 IBERIA ST
Practice Address - Street 2:
Practice Address - City:YOUNGSVILLE
Practice Address - State:LA
Practice Address - Zip Code:70592-5738
Practice Address - Country:US
Practice Address - Phone:337-856-1717
Practice Address - Fax:337-856-1818
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA0249225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAB4436OtherBLUE CROSS/BLUE SHIELD
LA650012867 E0303OtherRAILROAD MEDICARE
LA2966015OtherCIGNA
LA70592 A003OtherCHAMPUS