| Organization Name: | MINUTE MED CLINIC-VEROT LLC |
| NPI Number: | 1740612712 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRAD ALAN BOUDREAUX (OWNER) |
| Mailing Address: | 626 Verot School Rd Suite F Lafayette |
| State: | LA US |
| Postal Code: | 705085094 |
| Phone Number: | 3374126650 |
| Fax Number: | |
| NPI Enumeration Date: | 08/01/2013 |
| NPI Last Update Date: | 08/01/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |