1497062889 NPI number — DR. RACHEL ANDERS DUREL D.D.S.

Table of content: DR. RACHEL ANDERS DUREL D.D.S. (NPI 1497062889)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497062889 NPI number — DR. RACHEL ANDERS DUREL D.D.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DUREL
Provider First Name:
RACHEL
Provider Middle Name:
ANDERS
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.D.S.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ANDERS
Provider Other First Name:
RACHEL
Provider Other Middle Name:
RATCLIFF
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.D.S.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1497062889
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/13/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
335 DOUCET RD
Provider Second Line Business Mailing Address:
SUITE B
Provider Business Mailing Address City Name:
LAFAYETTE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70503-3497
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
337-981-8144
Provider Business Mailing Address Fax Number:
337-981-4994

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
335 DOUCET RD
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
LAFAYETTE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70503-3497
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
337-981-8144
Provider Business Practice Location Address Fax Number:
337-981-4994
Provider Enumeration Date:
09/07/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  6120 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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