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General NPI Number Information
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NPI Number | 1801121942
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Entity Type | Organization
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Legal Business Name | OUR LADY OF LOURDES PRIMARY CARE NETWORK
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Dates
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Enumeration Date | 10/07/2009
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Last Update Date | 03/18/2010
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Provider Practice Location Address
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Address Line | 805 ALBERTSON PKWY STE B
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City | BROUSSARD
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State | LA
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Zip | 70518-4350
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Country | US
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Telephone | 337-837-2664
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Fax | 337-837-2551
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Provider Business Mailing Address
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Address Line | 805 ALBERTSON PKWY STE B
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City | BROUSSARD
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State | LA
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Zip | 70518-4350
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Country | US
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Telephone | 337-837-2664
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Fax | 337-837-2551
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Authorized Official
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Title or Position | PHYSICIAN/ OPERATOR
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Name | BRIGITTE L GIROUARD
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Credential | MD
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Telephone | 337-837-2664
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 202732
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License Number State | LA
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