Lisa Boudreaux, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1145803 Issued in TX

Practice address

3141 Hood St Ste 410
Dallas, TX 75219-5019

Phone

(214) 998-4070

Fax

(214) 710-2189

NPI assigned

Oct 23, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fleur de Lis Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • New Orleans, LA
  • NPI 1134204167

  Physical Therapist

  NPD (past)
• Magnolia Physical Therapy, LLC

  • Physical Therapist
  • Harahan, LA
  • NPI 1316083447
  NPD (past)
• SF Sports MD & Rehab

  • Physical Therapist
  • Santa Fe, NM
  • NPI 1619470861
  NPD (past)
• SF Sports Med & Rehab Inc

  • Physical Therapist
  • Santa Fe, NM
  • NPI 1316933344
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370217600000",
    "number": "1043393028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3141 HOOD ST STE 410",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752195019",
            "telephone_number": "214-998-4070",
            "fax_number": "214-710-2189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3141 HOOD ST STE 410",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752195019",
            "telephone_number": "214-998-4070",
            "fax_number": "214-710-2189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDREAUX",
        "first_name": "LISA",
        "name_prefix": "Ms.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2013-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1145803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Marie Boucher, RDH
• Margery Dee Elledge Boucher, MA, MS, LPC
• Jasmine Miriam Boudjellali, RN
• Jill Christine Boudreaux, APRN-CNP
• John Kelly Boudreaux, MD
• Lisa A Boudreaux, CRNA
• Lydia R Boudreaux, PT, SIPT CERT
• Sydney Jeanne Boudreaux, DO
• Billy Bruce Boughton, RPH
• Shayla Bouie, MEDICAL ASSISTANT

• Physical Therapist in Dallas, TX
• Providers in Dallas, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.