Provider Demographics
NPI:1316276397
Name:VEILLON, TERRY JAMES JR (PHARMD)
Entity type:Individual
Prefix:
First Name:TERRY
Middle Name:JAMES
Last Name:VEILLON
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 DARWIN CIR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-7110
Mailing Address - Country:US
Mailing Address - Phone:337-296-1382
Mailing Address - Fax:337-889-3172
Practice Address - Street 1:104 DARWIN CIR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-7110
Practice Address - Country:US
Practice Address - Phone:337-296-1384
Practice Address - Fax:337-889-3172
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-21
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA18988183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1804690Medicaid