Provider Demographics
NPI:1316292980
Name:WILLIAM ANDRE CENAC M.D.
Entity type:Organization
Organization Name:WILLIAM ANDRE CENAC M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ANDRE
Authorized Official - Last Name:CENAC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-364-3000
Mailing Address - Street 1:1307 OLD JEANERETTE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70563-5801
Mailing Address - Country:US
Mailing Address - Phone:337-364-5333
Mailing Address - Fax:
Practice Address - Street 1:1307 OLD JEANERETTE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70563-5801
Practice Address - Country:US
Practice Address - Phone:337-364-5333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-19
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.017658261QA1903X, 261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1358941Medicaid
LA1358941Medicaid