Provider Demographics
NPI:1528238300
Name:ACADIANA HEARING CENTER
Entity type:Organization
Organization Name:ACADIANA HEARING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:J
Authorized Official - Last Name:CAVALIER
Authorized Official - Suffix:III
Authorized Official - Credentials:MS, CCC-A
Authorized Official - Phone:337-364-9156
Mailing Address - Street 1:425 E SAINT PETER ST
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70560-3752
Mailing Address - Country:US
Mailing Address - Phone:337-364-9156
Mailing Address - Fax:337-560-1627
Practice Address - Street 1:425 E SAINT PETER ST
Practice Address - Street 2:
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70560-3752
Practice Address - Country:US
Practice Address - Phone:337-364-9156
Practice Address - Fax:337-560-1627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-07
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3596231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1686077Medicaid