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Organization
PEDIATRIC GROUP OF ACADIANA, LLC
Active
Organization
PEDIATRIC GROUP OF ACADIANA, LLC
Active
Other names
Waterway Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
ANTOINETTE RABENALDT (CREDENTIALING COORDINATOR)
(337) 330-2576
Entity
Organization
Contact information
Practice address
12713 WATER WAY, MAUREPAS, LA 70449-1200
(225) 698-0211
(225) 424-6009
Mailing address
302 HACKER ST, NEW IBERIA, LA 70560-4508
(337) 330-2576
(337) 321-6295
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
01/18/2019
Last updated
12/03/2024
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