Organization
BENNETT BOUSTANY FONTENOT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN GAST (MANAGER)
(985) 635-6943
Entity
Organization
Contact information
Practice address
5000 AMBASSADOR CAFFERY PKWY STE 101, LAFAYETTE, LA 70508-6984
(504) 390-4619
Mailing address
5000 AMBASSADOR CAFFERY PKWY STE 101, LAFAYETTE, LA 70508-6984
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Enumeration date
11/29/2023
Last updated
11/30/2023
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