Broussard, Stephanie L

Broussard, Stephanie L is an individual health care provider with primary practice located at 6410 Fannin St 500, Houston TX 77030-3000. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Neonatal, which is considered as her primary health care specialty. Broussard, Stephanie L can be contacted via phone (832) 325-7111.

Contact Information

Primary practice address
6410 Fannin St 500 Houston TX 77030-3000
Phone: (832) 325-7111
Fax: (713) 512-2227
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Neonatal 363LN0000X 670437 Texas

Profile Details

NPI number 1851597504
LBN Legal business name Broussard, Stephanie L
Credentials NNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2007
Last updated Feb 10th, 2022 - about 3 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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Identifiers

StateTypeNumberIssuer
All States NPI 1851597504 NPPES
Texas Other 8Y3004 BCBS
Texas MEDICAID 189514601 BCBS
Texas Other 189514602 BCBS

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