Individual
DR. DEBORAH ANN BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
3501 SEVERN AVE, SUITE 15, METAIRIE, LA 70002-3451
(504) 455-6767
Mailing address
3501 SEVERN AVE, SUITE 15, METAIRIE, LA 70002-3451
(504) 455-6767
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1607-640T
LA
152W00000X
Optometrist
Primary
6060TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
81184Q
BCBS PIN
TX
Enumeration date
08/16/2006
Last updated
06/11/2012
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