Patty E. Boustany, M.D.
Individual provider Active NPI Anatomic Pathology & Clinical Pathology Physician · Terrytown, LA
NPI 1316010663 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1316010663
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician 207ZP0102X
- License
- MD019014 (LA)
- Practice address
- 2500 Belle Chasse Hwy
Terrytown, LA 70056-7127 - Phone
- (504) 391-7778
- NPI assigned
- Nov 16, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD019014 | LA | MD | Anatomic Pathology & Clinical Pathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tenet Healthsystem Memorial Medical Center, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | MD019014 | LA | Yes |
Addresses
Primary practice location
2500 Belle Chasse Hwy
Terrytown, LA 70056-7127
Mailing address
2404 Audubon Trce
Jefferson, LA 70121-1554
Other providers in Terrytown, LA
- Bone and Joint Therapy Services
- Kathyrn S Bonvillian
- Carolyn Carnes Borne
- Ann Borreson
- Emma Treuil Bouligny
- Kenesha Bradley
- Cassandra Denise Brandon
- Robbin Marie Brehm
- Lillian Broome
- Alonquin Brown
All providers in Terrytown, LA · Anatomic Pathology & Clinical Pathology Physician in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.