Lisa Breaux Black, MD

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

LISA BREAUX BLACK, MD

Practice address

895 Verret St
Houma, LA 70360-4635

Phone

(985) 200-3225

Fax

(985) 746-1204

NPI assigned

May 15, 2019

Organization subpart

No

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

Authorized official

Name

Heather Malbrough

Title

Office Administrator

Phone

(985) 665-9173

Specialties & licenses 1

Addresses

Other names 1

• La Vie A Family Practice Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert W Davis, MD

  • Internal Medicine Physician
  • Houma, LA
  • NPI 1750306999
  NPD (past)

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

{
    "created_epoch": "1557878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1164088134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "895 VERRET ST",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703604635",
            "telephone_number": "985-200-3225",
            "fax_number": "985-746-1204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 VERRET ST",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703604635",
            "telephone_number": "985-200-3225",
            "fax_number": "985-746-1204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA BREAUX BLACK, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-15",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "MALBROUGH",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "985-665-9173"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "La Vie A Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christina Marie Lirette, PMHNP
• Courtney Boudet Lirette, MCD, CCC-SLP
• Jackie Ann Lirette, M.S., CCC-SLP
• Sandi Lirette, M.A., PLPC
• Spring Lirette
• Phillip Anthony Livas
• Shanell Renee Livas
• Reese Crawford Locke, MD
• Jeffrey P. Long, MD
• Sheridene Leigh Long, LCSW

• Primary Care Clinic/Center in Houma, LA
• Providers in Houma, LA by specialty
• Primary Care Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.