Healthcare Provider Details
I. General information
NPI: 1083713101
Provider Name (Legal Business Name): LOUISIANA EAR, NOSE, & THROAT SPECIALISTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/22/2006
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
604 N ACADIA RD STE 101
THIBODAUX LA
70301-4847
US
IV. Provider business mailing address
604 N ACADIA RD STE 101
THIBODAUX LA
70301-4847
US
V. Phone/Fax
- Phone: 985-446-5079
- Fax: 985-447-2497
- Phone: 985-446-5079
- Fax: 985-447-2497
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Y00000X |
| Taxonomy | Otolaryngology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
PAUL
T.
GAUDET
Title or Position: PRESIDENT
Credential: M.D.
Phone: 985-446-5079