Provider Demographics
NPI:1487742839
Name:DAIGLE,HIMEL & DAIGLE PT CENTER
Entity type:Organization
Organization Name:DAIGLE,HIMEL & DAIGLE PT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EDDIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:HIMEL
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT
Authorized Official - Phone:985-876-1155
Mailing Address - Street 1:808 BAYOU LANE
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301
Mailing Address - Country:US
Mailing Address - Phone:985-447-3164
Mailing Address - Fax:985-447-5196
Practice Address - Street 1:808 BAYOU LANE
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301
Practice Address - Country:US
Practice Address - Phone:985-447-3164
Practice Address - Fax:985-447-5196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA01402225100000X
LA01848225100000X
LA00012R225100000X
LA00443225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA56401Medicare ID - Type UnspecifiedMEDICARE PROVIDER#
LA5T739Medicare ID - Type UnspecifiedMEDICARE PROVIDER#
LA5T790Medicare ID - Type UnspecifiedBLUECROSS OF LA
LA4H565Medicare ID - Type UnspecifiedMEDICARE PROVIDER#