Organization
LISA BREAUX BLACK, MD
Active
Other names
La Vie A Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER MALBROUGH (OFFICE ADMINISTRATOR)
(985) 665-9173
Entity
Organization
Contact information
Practice address
895 VERRET ST, HOUMA, LA 70360-4635
(985) 200-3225
(985) 746-1204
Mailing address
895 VERRET ST, HOUMA, LA 70360-4635
(985) 200-3225
(985) 746-1204
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
05/15/2019
Last updated
06/11/2019
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