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Organization
ACADIANA VASCULAR CENTER, LLC
Active
Organization
ACADIANA VASCULAR CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER E LAGRAIZE MD (OWNER)
(337) 289-9700
Entity
Organization
Contact information
Practice address
129 RUE LOUIS XIV, LAFAYETTE, LA 70508-5738
(337) 289-9700
(337) 289-9702
Mailing address
129 RUE LOUIS XIV, LAFAYETTE, LA 70508-5738
(337) 289-9700
(337) 289-9702
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
NULL
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1445819
—
LA
01
—
14474R
MEDICAL LICENSE
LA
01
—
435889460A
BLUE CROSS
LA
01
—
5CH18
MEDICARE PTAN
LA
Enumeration date
04/27/2007
Last updated
02/18/2020
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