Broussard Primary Care, Llc | |
3301 S Alameda St Ste 212 Corpus Christi TX 78411-1892 | |
(361) 452-2480 | |
(361) 452-2484 |
Full Name | Broussard Primary Care, Llc |
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Speciality | Internal Medicine |
Location | 3301 S Alameda St Ste 212, Corpus Christi, Texas |
Authorized Official Name and Position | Craig V Broussard (PHYSICIAN/OWNER) |
Authorized Official Contact | 3372634104 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Broussard Primary Care, Llc 3301 S Alameda St Ste 212 Corpus Christi TX 78411-1892 Ph: (361) 452-2480 | Broussard Primary Care, Llc 3301 S Alameda St Ste 212 Corpus Christi TX 78411-1892 Ph: (361) 452-2480 |
NPI Number | 1538909189 |
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Provider Enumeration Date | 05/30/2024 |
Last Update Date | 05/30/2024 |
Medicare PECOS PAC ID | 9739610049 |
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Medicare Enrollment ID | O20240926003840 |
Identifier | Type | State | Issuer |
---|---|---|---|
1538909189 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Craig V Broussard |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1609838861 PECOS PAC ID: 6800854555 Enrollment ID: I20241029003838 |
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