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Contact Information

BRAD BROUSSARD, MD
155 HOSPITAL DR. STE 206
LAFAYETTE, LA70503
 Phone: 337-234-3204
 Fax: 337-234-3599
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Critical Care Medicine

207RC0200X 11 Physician/Internal Medicine
 

Pulmonary Disease

207RP1001X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for BRAD BROUSSARD · (Male)

NPI # 1275551509
Status Active
Credentials MD
Entity Individual
Enumeration date 07/17/2006
Last updated 09/04/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • TX License # M3171
  • TX Medicaid 181131701
  • Other P00473770 RR MCR
  • TX Other 8DCN 1365642 TICKET BCBS
  • TX Other 8M1458 BCBS TX PROVIDER NO.
Hospital affiliation(s)
  • LAFAYETTE GENERAL MEDICAL CENTER - (Acute Care)
    1214 COOLIDGE AVENUE
    LAFAYETTE, LA 70503
  • UNIVERSITY MEDICAL CENTER - (Acute Care)
    2390 WEST CONGRESS
    LAFAYETTE, LA 70506
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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