# PEDIATRIC GROUP OF ACADIANA LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pediatric Group of Acadiana & Family Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073973533
- **Authorized official:** ANTOINETTE RABENALDT (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (337) 330-2576

## Contact information

- **Practice address:** 550 WEST VETERANS MEMORIAL DRIVE, ERATH, LA 70533-3430
- **Practice address phone:** (337) 918-6341
- **Practice address fax:** (337) 918-6346
- **Mailing address:** 302 HACKER ST, NEW IBERIA, LA 70560-4508
- **Mailing address phone:** (337) 330-2576
- **Mailing address fax:** (337) 321-6295

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | LA | Yes |

## Other

- **Enumeration date:** 02/26/2016
- **Last updated:** 12/03/2024