NPIMap

Organization Active NPI

E. Paul Breaux III MD PMC

  • Surgery Physician
  • Lafayette, LA
National Provider Identifier
1316991722
Registry record updated Jul 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
E. PAUL BREAUX III MD PMC
Practice address
917 Coolidge Blvd
Lafayette, LA 70503-2433
Phone
(337) 237-5774
Fax
(337) 237-4939
NPI assigned
May 20, 2006
Last updated
Jul 13, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2007

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

Authorized official

Name
Dr. Edgar Paul Breaux III, M.D.NPI 1982659165
Title
Owner/Managing Member
Phone
(337) 237-5774

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X
Surgery Physician 208600000X Primary
Surgical Oncology Physician 2086X0206X

Addresses

Primary practice location

917 Coolidge Blvd
Lafayette, LA 70503-2433

Mailing address

917 Coolidge Blvd
Lafayette, LA 70503-2433
Phone (337) 237-5774

Other identifiers 2

IdentifierTypeStateIssuer
DE1593OtherLAGROUP RAILROAD MEDICARE #
1799467MedicaidLA

National Provider Directory

National Provider Directory

Locations

917 Coolidge Blvd
Lafayette, LA 70503
Phone (337) 237-5774

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184284800000",
    "number": "1316991722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 COOLIDGE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032433",
            "telephone_number": "337-237-5774",
            "fax_number": "337-237-4939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 COOLIDGE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032433",
            "telephone_number": "337-237-5774",
            "fax_number": "337-237-4939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E. PAUL BREAUX III MD PMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2007-07-13",
        "status": "A",
        "authorized_official_last_name": "BREAUX",
        "authorized_official_first_name": "EDGAR",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "OWNER/MANAGING MEMBER",
        "authorized_official_telephone_number": "337-237-5774",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP RAILROAD MEDICARE #",
            "identifier": "DE1593",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1799467",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2007; 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.