| Doctor Name: | MR. THOMAS L BRISCOE |
| NPI Number: | 1992796189 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PHARMACIST |
| License Number: | A10327.RX |
| Business Practice Address: | 1620 S Main St Saint Martinville, LA - 705824310 |
| Business Phone Number: | 3373949772 |
| Business Fax Number: | 3373949773 |
| Mailing Address: | 400 Mill Pond Dr, YOUNGSVILLE |
| State: | LA |
| Postal Code: | 705925668 |
| Phone Number: | 3372419269 |
| Fax Number: | |
| NPI Enumeration Date: | 11/04/2005 |
| NPI Last Update Date: | 11/12/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | A10327.RX |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | LA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |