Healthcare Provider Details

I. General information

NPI: 1609397942
Provider Name (Legal Business Name): AUBREY LEKEENAN PALMER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: AUBREY PALMER MD

II. Dates (important events)

Enumeration Date: 06/27/2017
Last Update Date: 05/13/2024
Certification Date: 05/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4864 JACKSON ST
MONROE LA
71202-6400
US

IV. Provider business mailing address

301 UNIVERSITY BLVD
GALVESTON TX
77555-1385
US

V. Phone/Fax

Practice location:
  • Phone: 318-330-7000
  • Fax:
Mailing address:
  • Phone: 409-772-2166
  • Fax: 409-772-2663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number323442
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberBP10060861
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number323442
License Number StateLA
# 4
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberS6272
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: