Healthcare Provider Details

I. General information

NPI: 1831894690
Provider Name (Legal Business Name): ALEXANDRA C BUJOSA PAGAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2023
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 GAUSE BLVD
SLIDELL LA
70458-2939
US

IV. Provider business mailing address

1001 GAUSE BLVD
SLIDELL LA
70458-2939
US

V. Phone/Fax

Practice location:
  • Phone: 985-280-2200
  • Fax:
Mailing address:
  • Phone: 985-280-2200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number351711
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: