MEDICARE: MR. FRANK R BACQUE M.D.

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	174400000X	Specialist	011987	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093794299
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. FRANK R BACQUE M.D.

Provider Business Mailing Address
First Line	:	602 SAINT LANDRY ST
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70506-4628
Country	:	US
Telephone Number	:	337-235-1200
Fax Number	:	337-237-1021

Provider Business Practice Location Address
First Line	:	602 SAINT LANDRY ST
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70506-4628
Country	:	US
Telephone Number	:	337-235-1200
Fax Number	:	337-237-1021

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

Provider Enumeration Date	:	01/16/2006
Last Update Date	:	07/08/2007

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