Deborah Ann Broussard, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

6060TG Issued in TX

Practice address

3501 Severn Ave
Suite 15
Metairie, LA 70002-3451

Phone

(504) 455-6767

NPI assigned

Aug 16, 2006

Last updated

Jun 11, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339372800000",
    "number": "1568575561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 SEVERN AVE",
            "address_2": "SUITE 15",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700023451",
            "telephone_number": "504-455-6767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 SEVERN AVE",
            "address_2": "SUITE 15",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700023451",
            "telephone_number": "504-455-6767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "DEBORAH",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2012-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6060TG",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "1607-640T",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "81184Q",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rita Broughton, LPN
• Lynn Brouillette
• Colleen Elaine Broussard, CCC-SLP
• Courtney J Broussard, CRNA
• Crystal Broussard, PHD, LCSW
• Erika May Broussard, FNP
• Jamie W Broussard, MD
• Laverne Broussard
• Madeleine Marie Barbara Broussard
• Mandy L Broussard, CRNA

• Optometrist in Metairie, LA
• Providers in Metairie, LA by specialty
• Optometrist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2012; 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.