Individual
CHAD W LEDOUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
424 W MCNEESE ST, LAKE CHARLES, LA 70605-5547
(337) 478-0511
(337) 478-5644
Mailing address
424 W MCNEESE ST, LAKE CHARLES, LA 70605-5547
(337) 478-0511
(337) 478-5644
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
RN104066-AP05228
LA
367500000X
Certified Registered Nurse Anesthetist
726194
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
190446801
—
TX
01
—
86505U
BLUE CROSS PROVIDER ID
TX
01
—
P00394525
RAILROAD MEDICARE
—
Enumeration date
07/24/2006
Last updated
10/12/2016
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