Organization Active NPI

Haydel Asthma & Allergy Clinic

  • Medical Specialty Clinic/Center
  • Houma, LA
National Provider Identifier
1184708661
Registry record updated Mar 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
019894 Issued in LA
Legal business name
HAYDEL ASTHMA & ALLERGY CLINIC
Practice address
869 Verret St
Houma, LA 70360-4635
Phone
(985) 868-7566
Fax
(985) 851-4778
NPI assigned
Oct 24, 2006
Last updated
Mar 6, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Robert Douglas Haydel Jr., M. D.NPI 1891791240
Title
Officer/Director
Phone
(985) 868-7566

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 019894 LA Primary

Addresses

Primary practice location

869 Verret St
Houma, LA 70360-4635

Mailing address

869 Verret St
Houma, LA 70360-4635
Phone (985) 868-7566

Other identifiers 1

IdentifierTypeStateIssuer
1966444MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071019000156 LA Part B Supplier - Clinic/Group Practice 8729174933 Receives reassigned benefits from 1 practitioner
Practice locations: Houma, LA

National Provider Directory

National Provider Directory

Locations

4752 Highway 311
Ste 108
Houma, LA 70360
Phone (985) 857-8271

869 Verret St
Houma, LA 70360
Phone (985) 868-7566

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204761600000",
    "number": "1184708661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "869 VERRET ST",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703604635",
            "telephone_number": "985-868-7566",
            "fax_number": "985-851-4778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "869 VERRET ST",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703604635",
            "telephone_number": "985-868-7566",
            "fax_number": "985-851-4778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAYDEL ASTHMA & ALLERGY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2008-03-06",
        "status": "A",
        "authorized_official_last_name": "HAYDEL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "OFFICER/DIRECTOR",
        "authorized_official_telephone_number": "985-868-7566",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "LA",
            "license": "019894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1966444",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houma, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.