Provider Demographics
NPI:1194729079
Name:CARDIOLOGY CENTER OF ACADIANA, INC.
Entity type:Organization
Organization Name:CARDIOLOGY CENTER OF ACADIANA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ZIAD
Authorized Official - Last Name:DIBBS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-984-9355
Mailing Address - Street 1:121 RUE LOUIS XIV BLDG 4
Mailing Address - Street 2:SUITE B
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-5738
Mailing Address - Country:US
Mailing Address - Phone:337-984-9355
Mailing Address - Fax:337-984-9592
Practice Address - Street 1:121 RUE LOUIS XIV BLDG 4
Practice Address - Street 2:SUITE B
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-5738
Practice Address - Country:US
Practice Address - Phone:337-984-9355
Practice Address - Fax:337-984-9592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-09
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA14398R207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1448559Medicaid
LA5CF51Medicare PIN
LADC3481Medicare PIN