Provider Demographics
NPI:1821269127
Name:HECTOR A ROBLES, MD, LLC
Entity Type:Organization
Organization Name:HECTOR A ROBLES, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:Y
Authorized Official - Last Name:ROBLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-237-7997
Mailing Address - Street 1:501 W SAINT MARY BLVD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-4600
Mailing Address - Country:US
Mailing Address - Phone:337-237-7997
Mailing Address - Fax:337-237-6101
Practice Address - Street 1:501 W SAINT MARY BLVD
Practice Address - Street 2:SUITE 112
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-4600
Practice Address - Country:US
Practice Address - Phone:337-237-7997
Practice Address - Fax:337-237-6101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1492868Medicaid
LA1492868Medicaid