Provider Demographics
NPI:1245201730
Name:LACOMBE, DOUGLAS KEITH (CRNA)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:KEITH
Last Name:LACOMBE
Suffix:
Gender:
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 RAY MILNER RD
Mailing Address - Street 2:
Mailing Address - City:IOTA
Mailing Address - State:LA
Mailing Address - Zip Code:70543-4300
Mailing Address - Country:US
Mailing Address - Phone:337-250-0533
Mailing Address - Fax:
Practice Address - Street 1:1701 OAK PARK BLVD
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-8911
Practice Address - Country:US
Practice Address - Phone:337-494-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRN752822367500000X
TXAP1156860367500000X
TX752822367500000X
LAAP03650367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX288059301Medicaid
TXP01030980OtherRAILROAD
TX8854UBOtherBCBS
TX8854UBOtherBCBS
TX288059301Medicaid