Provider Demographics
NPI:1023268117
Name:BILLEDEAUX, FREDERICK W (BC-HIS,ACA)
Entity type:Individual
Prefix:
First Name:FREDERICK
Middle Name:W
Last Name:BILLEDEAUX
Suffix:
Gender:M
Credentials:BC-HIS,ACA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4414 JOHNSTON ST STE D
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-4253
Mailing Address - Country:US
Mailing Address - Phone:337-989-4327
Mailing Address - Fax:337-984-7914
Practice Address - Street 1:4414 JOHNSTON ST STE D
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-4253
Practice Address - Country:US
Practice Address - Phone:337-989-4327
Practice Address - Fax:337-989-4609
Is Sole Proprietor?:No
Enumeration Date:2008-09-24
Last Update Date:2020-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80185237700000X
MSHA0630237700000X
LA1078237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist