MEDICARE: LYDIA MICHELLE RABON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	323988	LA
2	2080P0204X	Pediatric Emergency Medicine (Pediatrics) Physician	323988	LA
3	2080P0204X	Pediatric Emergency Medicine (Pediatrics) Physician	U7352	TX

General Provider Information

NPI Number	:	1013250521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYDIA MICHELLE RABON MD

Provider Business Mailing Address
First Line	:	200 HENRY CLAY AVE
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70118-5798
Country	:	US
Telephone Number	:	504-899-9511
Fax Number	:

Provider Business Practice Location Address
First Line	:	1102 BATES AVE
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2698
Country	:	US
Telephone Number	:	832-824-1000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2013
Last Update Date	:	01/31/2024

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