# PEDIATRIC GROUP OF ACADIANA, LLC

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

## Provider details

- **NPI number:** 1255941829
- **Authorized official:** ALEC MOYER (BUSINESS MANAGER)
- **Authorized official phone:** (337) 330-8336

## Contact information

- **Practice address:** 555 LAKES BLVD, BREAUX BRIDGE, LA 70517-3240
- **Practice address phone:** (337) 332-3971
- **Mailing address:** 401 YOUNGSVILLE HWY STE 100, LAFAYETTE, LA 70508-5173
- **Mailing address phone:** (337) 256-5111

## Taxonomy

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

## Other

- **Enumeration date:** 08/07/2020
- **Last updated:** 08/07/2020