MEDICARE: JOSEPH EDWARD ORGERON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	M7495	TX
2	207Q00000X	Family Medicine Physician	200343	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8S5304	OTHER	TX	BCBS PIN

General Provider Information

NPI Number	:	1215032479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH EDWARD ORGERON MD

Provider Business Mailing Address
First Line	:	PO BOX 919229
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75391-9229
Country	:	US
Telephone Number	:	337-289-8944
Fax Number	:

Provider Business Practice Location Address
First Line	:	4906 AMBASSADOR CAFFERY PKWY
Second Line	:	SUITE 1302
City	:	LAFAYETTE
State	:	LA
Zip	:	70508-6962
Country	:	US
Telephone Number	:	337-534-8964
Fax Number	:	337-534-8966

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	02/06/2020

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