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
—
—
Other
Enumeration date
01/18/2019
Last updated
12/03/2024
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