BROUSSARD FAMILY PRACTICE, PLLC (NPI# 1710320908) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710320908 |
| Entity Type | Organization |
| Organization Name | BROUSSARD FAMILY PRACTICE, PLLC |
| Practice Address |
810 Hospital Dr Ste 100 Beaumont TX 77701-4633 |
| Mailing Address |
Po Box 7096 Beaumont TX 77726-7096 |
| Practice Telephone | 4098330342 |
| Mailing Telephone | (409) 833-0342 |
| Mailing Fax Number | 8777704091 |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | MRS. JULIETTE ROSE BROUSSARD (FAMILY NURSE PRACTITIONER/OWNER) |
| Authorized Official Telephone | 4098330342 |
| Authorized Official Credential | FNPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
651610 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 174400000X | Specialist | L2891 | TX | Other Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7675 Folsom Dr Ste 300b, Beaumont, TX 777067299 | 4098330342 | 8777704091 |
| Street Address |
810 HOSPITAL DR STE 100 |
| City | BEAUMONT |
| State | TX |
| Zip Code | 77701-4633 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891296604 | Jessica Paige Seago | Licensed Vocational Nurse | 3330 Fannin, Beaumont, TX 77701 | 2018-02-27 |
| 1154833135 | Shannon Denard | Naturopath | 1595 S. M.l. King Jr. Parkway, Beaumont, TX 77701 | 2017-10-30 |
| 1558818096 | Kelli North | Nurse Practitioner | 810 Hospital Dr Ste. 235, Beaumont, TX 77701 | 2016-09-01 |
| 1821446055 | La Costa of Beaumont Pa | Dentist | 3870 College Street, Suite #200, Beaumont, TX 77701 | 2016-05-27 |
| 1811361462 | Azuka Ginigeme | Pharmacist | 3605 College Street, Walgreens Pharmacy, Beaumont, TX 77701 | 2015-11-19 |
| 1093184921 | Coastal Spine & Pain Institute, Pllc | Specialist | 3070 College Street, Suite 300, Beaumont, TX 77701 | 2015-09-22 |
| 1831584663 | H-e-b, Lp | Clinical Medical Laboratory | 3590 College Street, Beaumont, TX 77701 | 2015-03-30 |
| 1205272648 | Yalanda S Jessie | Counselor | 755 S 11th St Ste 246, Beaumont, TX 77701 | 2013-05-13 |
| 1871856443 | Henry Clay Williams | Day Training, Developmentally Disabled Services | 2316 Orange St., Beaumont, TX 77701 | 2012-06-19 |
| 1053670398 | Park Infusioncare, Lp | Durable Medical Equipment & Medical Supplies | 3695 Stagg Dr, Beaumont, TX 77701 | 2012-05-07 |
| Find all providers in zip 77701 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841810306 | Abc Surgical, LLC | Specialist | 6 Twin Circle Dr, Beaumont, TX 77706-5304 | 2020-04-24 |
| 1093184921 | Coastal Spine & Pain Institute, Pllc | Specialist | 3070 College Street, Suite 300, Beaumont, TX 77701 | 2015-09-22 |
| 1265845978 | Jeremy Wampler | Specialist | 1676 E 6th St, Suite C, Beaumont, CA 92223-5760 | 2014-06-10 |
| 1649683632 | Dowlen Center for Pain LLC | Specialist | 6025 Metropolitan Dr Ste 200, Beaumont, TX 77706-2409 | 2014-06-06 |
| 1366659344 | Harry Whiteside | Specialist | 8750 Phelan Blvd, Beaumont, TX 77706-5133 | 2007-05-17 |
| 1316075013 | Plastic Surgery Associates LLP | Specialist | 950 N 11th St, Beaumont, TX 77702-1203 | 2007-03-02 |
| 1831270156 | Beaumont Radiology Group, LLP | Specialist | 4890 Dowlen Rd, Beaumont, TX 77708-4828 | 2006-10-17 |
| 1497774335 | Maria Luz Dayrit | Specialist | 4027 Dowlen Rd, Beaumont, TX 77706-6850 | 2006-07-19 |
| 1023050341 | Brent Lee Mainwaring | Specialist | 3405 College St, Beaumont, TX 77701-4613 | 2006-06-12 |
| 1275500647 | Jane C Angel | Specialist | 5035 Oakmont Dr, Beaumont, TX 77706-7640 | 2006-03-03 |
| Find all providers in BEAUMONT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.