Individual
PAUL A LEBOURGEOIS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
901 W BEN WHITE BLVD, SOUTH AUSTIN HOSPITAL PATHOLOGY DEPARTMENT, AUSTIN, TX 78704-6903
(512) 448-7100
(512) 416-6409
Mailing address
PO BOX 164106, AUSTIN, TX 78716-4106
(512) 448-7100
(512) 416-6409
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
E5566
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
80P645
BCBS OF TEXAS
—
Enumeration date
11/07/2005
Last updated
07/08/2007
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