Provider Demographics
NPI:1194995365
Name:CLAYTON J. BABINEAUX
Entity type:Organization
Organization Name:CLAYTON J. BABINEAUX
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:NONA
Authorized Official - Middle Name:
Authorized Official - Last Name:THERIOT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-235-6263
Mailing Address - Street 1:155 HOSPITAL DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-2852
Mailing Address - Country:US
Mailing Address - Phone:337-235-6263
Mailing Address - Fax:
Practice Address - Street 1:155 HOSPITAL DR
Practice Address - Street 2:SUITE 300
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2852
Practice Address - Country:US
Practice Address - Phone:337-235-6263
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4217310001Medicare NSC