Healthcare Provider Details

I. General information

NPI: 1124528807
Provider Name (Legal Business Name): ZACHARIAH JAMES HEBERT PLPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/19/2018
Last Update Date: 02/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1602 W PINHOOK RD SUITE 100A THE FAMILY TREE
LAFAYETTE LA
70508
US

IV. Provider business mailing address

108 DUNCAN DR
LAFAYETTE LA
70503
US

V. Phone/Fax

Practice location:
  • Phone: 337-981-2180
  • Fax:
Mailing address:
  • Phone: 337-988-0716
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberPLC6703
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: