LISA BREAUX BLACK, MD (NPI# 1164088134) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164088134 |
| Entity Type | Organization |
| Organization Name | LISA BREAUX BLACK, MD |
| Practice Address |
895 Verret St Houma LA 70360-4635 |
| Practice Telephone | 9852003225 |
| Practice Fax Number | 9857461204 |
| Mailing Telephone | 9852003225 |
| Mailing Fax Number | 9857461204 |
| Enumeration Date | 2019-05-15 |
| Last Update Date | 2019-06-11 |
| Authorized Official Name | HEATHER MALBROUGH (OFFICE ADMINISTRATOR) |
| Authorized Official Telephone | 9856659173 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| La Vie A Family Practice | Doing Business As Name - Organization |
| Street Address |
895 VERRET ST |
| City | HOUMA |
| State | LA |
| Zip Code | 70360-4635 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851484307 | Lisa Breaux Black | Family Medicine | 895 Verret St, Houma, LA 70360-4635 | 2006-10-02 |
| 1982264552 | Candice Roberts | Nurse Practitioner | 895 Verret St, Houma, LA 70360-4635 | 2019-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699382697 | Start Corporation | Clinic/Center | 106 School Street, Houma, LA 70360 | 2020-09-24 |
| 1013474196 | Christi Thibodeaux Rodrigue | Case Manager/Care Coordinator | 427west Tunnel Blvd, Houma, LA 70360 | 2019-02-26 |
| 1053801415 | Louisiana Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1420 Saint Charles St, Houma, LA 70360 | 2018-05-11 |
| 1447780044 | Shakira Harding | Counselor | 148 Columbus Street, Houma, LA 70360 | 2017-06-15 |
| 1639608995 | Rakitha Monique Volter-jones | Counselor | 6522 West Main Street, Houma, LA 70360 | 2017-06-08 |
| 1588103469 | Eyecare Specialties | Ophthalmology | 564 Valhi Blvd, Houma, LA 70360 | 2017-02-13 |
| 1538605464 | Houma Dental Associates, LLC | Dentist | 5934 West Main St, Houma, LA 70360 | 2017-01-17 |
| 1649721143 | Bio-medical Applications of Louisiana, LLC | Clinic/Center | 143 War Horse Place, Houma, LA 70360 | 2016-10-19 |
| 1528417045 | Mandi Gaubert Bonvillain | Psychologist | 1018 Verrett Street, Houma, LA 70360 | 2016-06-06 |
| 1295182434 | Kerry M Guidry | Chiropractor | 6902 West Main Street, Houma, LA 70360 | 2016-05-18 |
| Find all providers in zip 70360 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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|---|---|---|---|---|
| 1356973077 | Phca Houma LLC | Clinic/Center | 435 Corporate Dr Ste 402, Houma, LA 70360-2498 | 2020-02-11 |
| 1295110153 | All Access Walk-in Clinic | Clinic/Center | 855 Belanger St Ste 108, Houma, LA 70360-4401 | 2015-07-21 |
| 1942656228 | Physicians Medical Center LLC | Clinic/Center | 131 Corporate Dr, Houma, LA 70360-2767 | 2016-05-05 |
| 1811372527 | South Central Louisiana Human | Clinic/Center | 5599 Highway 311, Houma, LA 70360-2866 | 2015-07-23 |
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| 1992367791 | Family First Medical & Wellness Clinic, LLC | Clinic/Center | 300 Clay St, Kenner, LA 70062 | 2019-07-01 |
| 1366926040 | In and Out Urgent Care Covington, LLC | Clinic/Center | 13130 Hwy 1085, Suite 100, Covington, LA 70433-7829 | 2018-09-19 |
| 1588143556 | Pediatric Center of Many LLC | Clinic/Center | 315 S Highland Dr Ste A, Many, LA 71449-3719 | 2018-08-10 |
| 1508342239 | Audubon Palliative Care Services Inc | Clinic/Center | 9181 Interline Ave Ste 220, Baton Rouge, LA 70809-1900 | 2018-07-16 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.