Rayfus J Broussard, Dds Inc

LBN: Rayfus J Broussard, Dds Inc
Rayfus J Broussard, Dds Inc is an health care organization with primary practice located at 1120 Longfellow Dr , Beaumont TX 77706-4845. The organization recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as the primary health care specialty. Rayfus J Broussard, Dds Inc can be contacted via phone (409) 898-7847, or through Broussard, Rayfus J via phone (409) 898-7847.

Contact Information

Primary practice address
1120 Longfellow Dr Beaumont TX 77706-4845
Phone: (409) 898-7847
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Broussard, Rayfus J Doctor of Dental Surgery (DDS)
Phone: (409) 898-7847

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X 11407 Texas

Profile Details

NPI number 1669743498
LBN Legal business name Rayfus J Broussard, Dds Inc
DBA Doing business as
Authorized official Broussard, Rayfus J Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 25th, 2012
Last updated Jan 25th, 2012 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669743498 NPPES
Texas MEDICAID 164122701

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