Organization
BROUSSARD SURGERY INSTITUTE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANICA G NELSON (BUSINESS MANAGER)
(318) 387-2015
Entity
Organization
Contact information
Practice address
1250 PECANLAND RD, SUITE E-1, MONROE, LA 71203-7011
(318) 387-2015
(318) 387-2097
Mailing address
1250 PECANLAND RD, SUITE E-1, MONROE, LA 71203-7011
(318) 387-2015
(318) 387-2097
Taxonomy
Speciality
Code
Description
License number
State
261QS0132X
Ophthalmologic Surgery Clinic/Center
Primary
124
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1925276
—
LA
Enumeration date
06/20/2006
Last updated
08/22/2020
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