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General NPI Number Information
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NPI Number | 1033890611
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Entity Type | Individual
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Provider Name | KARLIE TROSCLAIR BREAUX PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/27/2023
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Last Update Date | 07/24/2024
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Provider Practice Location Address
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Address Line | 4308 ALLENBROOK DR
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City | BAYTOWN
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State | TX
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Zip | 77521-3200
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Country | US
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Telephone | 281-422-4141
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Fax | 281-422-5939
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Provider Business Mailing Address
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Address Line | 100 DAVIS DR
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City | THIBODAUX
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State | LA
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Zip | 70301-8022
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Country | US
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Telephone | 985-414-0775
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA18128
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License Number State | TX
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