Healthcare Provider Details

I. General information

NPI: 1366248106
Provider Name (Legal Business Name): JOSHUA BILLEDEAUX
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2025
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5530 JOHNSTON ST STE 300
LAFAYETTE LA
70503-5138
US

IV. Provider business mailing address

3411 AMBASSADOR CAFFERY PKWY
LAFAYETTE LA
70506-7519
US

V. Phone/Fax

Practice location:
  • Phone: 337-704-2228
  • Fax:
Mailing address:
  • Phone: 337-704-2228
  • Fax: 337-735-1919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number1381
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: