Individual provider Active NPI

Fernando E Palomeque, MD

  • Dermatology Physician
  • Houma, LA
National Provider Identifier
1417910464
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
009369 Issued in LA
Practice address
12 Professional Drive
Houma, LA 70360
Phone
(985) 868-1810
Fax
(985) 876-3670
NPI assigned
Apr 10, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 009369 LA Primary

Addresses

Primary practice location

12 Professional Drive
Houma, LA 70360

Mailing address

12 Professional Drive
Houma, LA 70360
Phone (985) 868-1810

Other identifiers 1

IdentifierTypeStateIssuer
1095303MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
009369LAMDDermatology Physician
014596LAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
William Wilder, Apmc Past Accepting new patients
P Mark Neal MD LLC Past Accepting new patients
Duke Neal Medical, LLC Dermatology Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1417910464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 PROFESSIONAL DRIVE",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "70360",
            "telephone_number": "985-868-1810",
            "fax_number": "985-876-3670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 PROFESSIONAL DRIVE",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "70360",
            "telephone_number": "985-868-1810",
            "fax_number": "985-876-3670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALOMEQUE",
        "first_name": "FERNANDO",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "LA",
            "license": "009369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1095303",
            "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 Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.