Provider Demographics
NPI:1366414666
Name:DARBONNE, DAVID PAUL (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:PAUL
Last Name:DARBONNE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 122585 DEPT 2585
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75312-0001
Mailing Address - Country:US
Mailing Address - Phone:337-494-2921
Mailing Address - Fax:337-494-6523
Practice Address - Street 1:1890 W GAUTHIER RD STE 135
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-7179
Practice Address - Country:US
Practice Address - Phone:337-480-5510
Practice Address - Fax:337-480-5511
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-02
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA021582207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1980072Medicaid
LA5W843C423Medicare ID - Type Unspecified
LA1980072Medicaid