Individual
DR. BEAU BROUILLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5541 HIGHWAY 1, MARKSVILLE, LA 71351-2650
(318) 240-7240
(318) 240-7180
Mailing address
919 HIDDEN RDG, FL 6, IRVING, TX 75038-3813
(469) 282-2713
(469) 282-2609
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M.D.024120
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1571091
—
LA
Enumeration date
06/01/2005
Last updated
09/01/2016
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