Individual
DR. BRAD ALAN BOUDREAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3619 AMBASSADOR CAFFERY PKWY, BLDG E, LAFAYETTE, LA 70503-5132
(337) 534-4410
(337) 534-4426
Mailing address
3619 AMBASSADOR CAFFERY PKWY, BLDG E, LAFAYETTE, LA 70503-5132
(337) 534-4410
(337) 534-4426
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
201157
LA
208D00000X
General Practice Physician
MD.201157
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1091570
—
LA
Enumeration date
11/02/2006
Last updated
01/21/2025
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