Provider Demographics
NPI:1801295738
Name:BABINEAUX, KATY
Entity type:Individual
Prefix:
First Name:KATY
Middle Name:
Last Name:BABINEAUX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3142 AMBASSADOR CAFFERY PKWY
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-7210
Mailing Address - Country:US
Mailing Address - Phone:337-989-4095
Mailing Address - Fax:337-989-4097
Practice Address - Street 1:3142 AMBASSADOR CAFFERY PKWY
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-7210
Practice Address - Country:US
Practice Address - Phone:337-989-4095
Practice Address - Fax:337-989-4097
Is Sole Proprietor?:No
Enumeration Date:2014-08-15
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA16889183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist