=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720053630
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ACADIANA HYPERBARICS, LTD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/22/2006
-----------------------------------------------------
Last Update Date | 08/29/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4212 WEST CONGRESS SUITE 1401
-----------------------------------------------------
City | LAFAYETTE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70506
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 337-234-4535
-----------------------------------------------------
Fax | 337-235-4272
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 204 BENT TREE TRAIL
-----------------------------------------------------
City | LAFAYETTE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70508
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 337-234-4535
-----------------------------------------------------
Fax | 337-235-4272
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. LUIS ALBERTO MEZA
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 337-234-4535
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RH0003X
-----------------------------------------------------
Taxonomy Name | Hematology & Oncology Physician
-----------------------------------------------------
License Number | 013868
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------