| Lisa Breaux Black, Md | |
|
895 Verret St Houma LA 70360-4635 | |
| (985) 200-3225 | |
| (985) 746-1204 |
| Full Name | Lisa Breaux Black, Md |
|---|---|
| Speciality | Clinic/Center |
| Location | 895 Verret St, Houma, Louisiana |
| Authorized Official Name and Position | Heather Malbrough (OFFICE ADMINISTRATOR) |
| Authorized Official Contact | 9856659173 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa Breaux Black, Md 895 Verret St Houma LA 70360-4635 Ph: (985) 200-3225 | Lisa Breaux Black, Md 895 Verret St Houma LA 70360-4635 Ph: (985) 200-3225 |
| NPI Number | 1164088134 |
|---|---|
| Provider Enumeration Date | 05/15/2019 |
| Last Update Date | 06/11/2019 |
| Medicare PECOS PAC ID | 3476887258 |
|---|---|
| Medicare Enrollment ID | O20190627002434 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164088134 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Lisa Black |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851484307 PECOS PAC ID: 4082706643 Enrollment ID: I20080709000257 |
| Provider Name | Candice Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982264552 PECOS PAC ID: 5597092007 Enrollment ID: I20190806004277 |
Gii Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 855 Belanger St, Suite 205, Houma, LA 70360 Phone: 985-868-7773 Fax: 985-868-4242 | |
Children's International, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 216 Mystic Blvd, Houma, LA 70360 Phone: 985-868-9339 Fax: 855-519-4481 | |
Physician Practice Partners Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8166 Main St, Houma, LA 70360 Phone: 985-873-4141 | |
Life Coast Community Health Center Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 605 Enterprise Dr Ste C, Houma, LA 70360 Phone: 985-360-3755 Fax: 985-879-4580 | |
Just Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 118 Armour Dr, Houma, LA 70364 Phone: 833-784-2669 Fax: 844-784-2329 | |
William H. St. Martin, M.d. A Professional Corpo Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 818 Verret Street, Houma, LA 70360 Phone: 985-857-8001 Fax: 985-857-8330 | |
Comprehensive Care Plus Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8120 Main St, Suite 403, Houma, LA 70360 Phone: 985-868-3737 Fax: 985-873-9997 |