Provider Demographics
NPI:1952354748
Name:BABINEAUX, LENDELL J (PT)
Entity type:Individual
Prefix:
First Name:LENDELL
Middle Name:J
Last Name:BABINEAUX
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 759
Mailing Address - Street 2:
Mailing Address - City:RAYNE
Mailing Address - State:LA
Mailing Address - Zip Code:70578-0759
Mailing Address - Country:US
Mailing Address - Phone:337-334-9207
Mailing Address - Fax:337-334-9207
Practice Address - Street 1:500 W BRANCHE ST
Practice Address - Street 2:
Practice Address - City:RAYNE
Practice Address - State:LA
Practice Address - Zip Code:70578-5026
Practice Address - Country:US
Practice Address - Phone:337-334-9207
Practice Address - Fax:337-334-9207
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPT0163225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA12269OtherPHYSICAL THERAPY-BC
LA59451Medicare ID - Type UnspecifiedPHYSICAL THERAPY