Healthcare Provider Details

I. General information

NPI: 1881863553
Provider Name (Legal Business Name): CARDIOLOGY SPECIALISTS OF ACADIANA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2008
Last Update Date: 06/22/2021
Certification Date: 06/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 RUE LOUIS XIV
LAFAYETTE LA
70508-5734
US

IV. Provider business mailing address

213 RUE FONTAINE
LAFAYETTE LA
70508-5742
US

V. Phone/Fax

Practice location:
  • Phone: 337-269-9777
  • Fax: 337-269-0244
Mailing address:
  • Phone: 337-269-9777
  • Fax: 337-269-0244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: JON D LELEUX
Title or Position: MEMBER
Credential: MD
Phone: 337-269-9777