Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SHANE T BROUSSARD, P.A.
ActivePhysician Assistant · LAFAYETTE, LA
Registration Details
- NPI Number
- 1164468435
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 22, 2006 (19.844215795642 yrs)
- Last Updated
- Feb 3, 2009
- License
-
A10272 (LA)
Practice Information
- Address
-
1103 KALISTE SALOOM ROADSUITE 102LAFAYETTE, LA, 705082920Browse LA providers · Browse ZIP 70508
- Phone
- 3372345234
- Fax
- 3372352121
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in LAFAYETTE, LA
| Name | Credential | NPI |
|---|---|---|
| JASON R COMEAUX | PA-C | 1104825371 |
| RYAN PAUL ARMENTOR | — | 1629042312 |
| MR. RICHARD RODNEY ROBIN | PA-C | 1437119070 |
| TODD A DEVALCOURT | P.A. | 1033150784 |
| DONNA JEANNE VIAL | PA | 1306878186 |
| MISS MARY MEAUX MANUEL | P.A. | 1356376065 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.