Broussard, Shane T

Broussard, Shane T is an individual health care provider with primary practice located at 1103 Kaliste Saloom Road Suite 102, Lafayette LA 70508-2920. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Broussard, Shane T can be contacted via phone (337) 234-5234.

Contact Information

Primary practice address
1103 Kaliste Saloom Road Suite 102 Lafayette LA 70508-2920
Phone: (337) 234-5234
Fax: (337) 235-2121
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X A10272 Louisiana

Profile Details

NPI number 1164468435
LBN Legal business name Broussard, Shane T
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2006
Last updated Feb 3rd, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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