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General NPI Number Information
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NPI Number | 1114178639
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Entity Type | Organization
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Legal Business Name | PATRICK DALE LELEUX JR MD LLC
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Dates
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Enumeration Date | 10/02/2008
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Last Update Date | 10/02/2008
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Provider Practice Location Address
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Address Line | 202 N. JACKSON
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City | KAPLAN
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State | LA
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Zip | 70548
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Country | US
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Telephone | 337-643-1655
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Fax | 337-643-1654
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Provider Business Mailing Address
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Address Line | PO BOX 1348
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City | CROWLEY
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State | LA
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Zip | 70527
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Country | US
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Telephone | 337-643-1655
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Fax | 337-643-1654
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Authorized Official
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Title or Position | PRESIDENT
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Name | PATRICK DALE LELEUX JR.
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Credential | MD
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Telephone | 337-643-1655
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD202105
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License Number State | LA
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