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NPI Code Detail

MEDICARE: OUR LADY OF LOURDES PRIMARY CARE NETWORK

MEDICARE: OUR LADY OF LOURDES PRIMARY CARE NETWORK
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
1207Q00000XFamily Medicine Physician202732LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11205044757OTHERLADR'S NPI
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
31801121942OTHERLAGROUP NPI

General Provider Information

NPI Number : 1801121942
Entity Type Code : Organization
Provider Name (Legal Business Name) : OUR LADY OF LOURDES PRIMARY CARE NETWORK
Provider Business Mailing Address
First Line : 805 ALBERTSON PKWY STE B
Second Line :
City : BROUSSARD
State : LA
Zip : 70518-4350
Country : US
Telephone Number : 337-837-2664
Fax Number : 337-837-2551
Provider Business Practice Location Address
First Line : 805 ALBERTSON PKWY STE B
Second Line :
City : BROUSSARD
State : LA
Zip : 70518-4350
Country : US
Telephone Number : 337-837-2664
Fax Number : 337-837-2551
Authorized Official
Title or Position : PHYSICIAN/ OPERATOR
Name : BRIGITTE L GIROUARD
Credential : MD
Telephone Number : 337-837-2664
Provider Enumeration Date : 10/07/2009
Last Update Date : 03/18/2010

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1265437438 — MRS. NATALIE BREAUX BLANCHARD PMHNP
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1225251986 — MISS MICHELE RENEE VINCENT LCSW
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1205044757 — DR. BRIGITTE LUQUETTE GIROUARD M.D.
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805 ALBERTSON PKWY STE B
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1710209044 — AIMEE C BROUSSARD APRN
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1538440094 — MRS. AMBER D LITTLEFIELD PMHNP-BC
Practice Location Address:
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70518-4350
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Practice Fax: 337-330-4732

Directions to “OUR LADY OF LOURDES PRIMARY CARE NETWORK ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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