Healthcare Provider Details

I. General information

NPI: 1134912116
Provider Name (Legal Business Name): VICTORIA BADEAUX MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2025
Last Update Date: 05/23/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401A JEFFERSON HWY
JEFFERSON LA
70121-2426
US

IV. Provider business mailing address

302 ABITA PL
MANDEVILLE LA
70471-1601
US

V. Phone/Fax

Practice location:
  • Phone: 504-842-3260
  • Fax: 504-842-3193
Mailing address:
  • Phone: 512-496-0584
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number346780
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: