| Shane T Broussard, PA | |
|
1103 Kaliste Saloom Road, Suite 102, Lafayette, LA 70508-2920 | |
| (337) 234-5234 | |
| (337) 235-2121 |
| Full Name | Shane T Broussard |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 1103 Kaliste Saloom Road, Lafayette, Louisiana |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164468435 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | A10272 (Louisiana) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Shane T Broussard, PA 1103 Kaliste Saloom Road, Suite 102, Lafayette, LA 70508-2920 Ph: (337) 234-5234 | Shane T Broussard, PA 1103 Kaliste Saloom Road, Suite 102, Lafayette, LA 70508-2920 Ph: (337) 234-5234 |
Stefanie Hummel Theriot, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 105 Patriot St Ste 101, Lafayette, LA 70508 Phone: 337-981-2125 Fax: 337-981-2174 | |
Kevin Kathleen M Menard, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1103 Kaliste Saloom Rd, Lafayette, LA 70508 Phone: 337-234-5234 | |
Katie Tso, Physician Assistant Medicare: Medicare Enrolled Practice Location: 118 Rue Fontaine, Lafayette, LA 70508 Phone: 337-534-8680 | |
Todd A Devalcourt, P.A. Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4212 W Congress St Ste 3100, Lafayette, LA 70506 Phone: 337-703-3201 Fax: 337-703-3202 | |
Banee Madison, P.A Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4600 Ambassador Caffery Pkwy, Lafayette, LA 70508 Phone: 337-561-9100 | |
Ms. Justine Michelle Guerrero, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 901 Wilson St, Lafayette, LA 70503 Phone: 337-456-6523 Fax: 337-456-6521 | |
Jason R Comeaux, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 935 Camellia Blvd, Ste 103, Lafayette, LA 70508 Phone: 337-534-4356 Fax: 337-534-4357 |