Basic Information
| Provider Information | |||||||||
| NPI: | 1740691831 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RABALAIS | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | GRANT | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1103 KALISTE SALOOM RD STE 304 | ||||||||
| Address2: | |||||||||
| City: | LAFAYETTE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 705085784 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3379885646 | ||||||||
| FaxNumber: | 3379884298 | ||||||||
| Practice Location | |||||||||
| Address1: | 1103 KALISTE SALOOM RD STE 304 | ||||||||
| Address2: | |||||||||
| City: | LAFAYETTE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 705085784 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3379885646 | ||||||||
| FaxNumber: | 3379884298 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/12/2014 | ||||||||
| LastUpdateDate: | 08/14/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207LP2900X | 311429 | LA | Y | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
No ID Information.