Provider Demographics
NPI:1952318503
Name:COMEAUX, MEGAN KING (OT)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:KING
Last Name:COMEAUX
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6209 CAMERON ST LOT 16
Mailing Address - Street 2:
Mailing Address - City:SCOTT
Mailing Address - State:LA
Mailing Address - Zip Code:70583-5194
Mailing Address - Country:US
Mailing Address - Phone:318-614-8692
Mailing Address - Fax:337-233-5270
Practice Address - Street 1:401 N COLLEGE RD
Practice Address - Street 2:STE. #3 & 4
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-4263
Practice Address - Country:US
Practice Address - Phone:337-233-5230
Practice Address - Fax:337-233-5270
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAOTT-.200072225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4H714CE52Medicare PIN