Provider Demographics
NPI:1215332770
Name:WM. ANDRE CENAC, MD APMC
Entity type:Organization
Organization Name:WM. ANDRE CENAC, MD APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ELEANOR
Authorized Official - Middle Name:M
Authorized Official - Last Name:LANDRY
Authorized Official - Suffix:
Authorized Official - Credentials:RHIA
Authorized Official - Phone:337-364-4440
Mailing Address - Street 1:1307 OLD JEANERETTE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70563-5801
Mailing Address - Country:US
Mailing Address - Phone:337-364-3000
Mailing Address - Fax:337-364-5333
Practice Address - Street 1:1307 OLD JEANERETTE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70563-5801
Practice Address - Country:US
Practice Address - Phone:337-364-3000
Practice Address - Fax:337-364-5333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-27
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD017658174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty