Provider Demographics
NPI:1912058215
Name:PIONEER ANESTHESIA AND PAIN ASSOCIATES, L.L.C.
Entity type:Organization
Organization Name:PIONEER ANESTHESIA AND PAIN ASSOCIATES, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOREEN
Authorized Official - Middle Name:TAN
Authorized Official - Last Name:ABADCO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-269-5600
Mailing Address - Street 1:PO BOX 80384
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70598-0384
Mailing Address - Country:US
Mailing Address - Phone:337-269-5600
Mailing Address - Fax:337-269-5812
Practice Address - Street 1:114 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2825
Practice Address - Country:US
Practice Address - Phone:337-269-5600
Practice Address - Fax:337-269-5812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-15
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11594R207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1679224Medicaid
LA5W771CH83Medicare PIN
LA5CH83Medicare PIN
LAG25662Medicare UPIN