Individual
MS. RITA BOUSTANY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4600 AMBASSADOR CAFFERY PKWY, LAFAYETTE, LA 70508-6902
(337) 470-2605
(337) 470-4595
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(337) 470-2605
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
37117
IA
208000000X
Pediatrics Physician
Primary
MD.203808
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2116436
—
LA
Enumeration date
03/21/2007
Last updated
12/03/2024
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