Doctor Name: | MR. JASON A BREAUX |
NPI Number: | 1619167517 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 26385 |
Business Practice Address: | 457 Heymann Blvd Lafayette, LA - 705032616 |
Business Phone Number: | 3372375774 |
Business Fax Number: | 3372374940 |
Mailing Address: | 457 Heymann Blvd, LAFAYETTE |
State: | LA |
Postal Code: | 705032616 |
Phone Number: | 3372375774 |
Fax Number: | 3372374940 |
NPI Enumeration Date: | 07/26/2007 |
NPI Last Update Date: | 01/28/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 26385 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | LA |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |