Daniel R. Bourque, M.D., a.P.M.C.
Organization Active NPI Obstetrics & Gynecology Physician · Lafayette, LA
NPI 1659688489 · NPPES record last updated Jun 20, 2023
Key facts
- NPI
- 1659688489
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 016161 (LA)
- Legal business name
- DANIEL R. BOURQUE, M.D., A.P.M.C.
- Practice address
- 435 Heymann Blvd
Lafayette, LA 70503-2616 - Phone
- (337) 234-3344
- Fax
- (337) 234-3352
- NPI assigned
- Aug 31, 2010
- Organization subpart
- No
Authorized official
- Name
- Daniel R. Bourque, M.D.
- Title
- Physician
- Phone
- (337) 234-3344
Practitioners 3
-
Daniel R Bourque, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101006001130 | LA | Part B Supplier - Clinic/Group Practice | 5092907220 |
Receives reassigned benefits from 3 practitioners Practice locations: Lafayette, LA |
National Provider Directory
Interoperability endpoints
- https://fhir.healthtogo.me/fhir/r4/imed.bourque
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician |
207V00000X | 016161 | LA | Yes |
Addresses
Primary practice location
435 Heymann Blvd
Lafayette, LA 70503-2616
Mailing address
435 Heymann Blvd
Lafayette, LA 70503-2616
Phone (337) 234-3344
Other providers in Lafayette, LA
- Tram Phuong Dang
- Trieu-Dinh Dang
- Daniel & Max, LLC
- Daniel L Hodges, MD, Apmc
- Daniel M. Escalona, M.D. a Medical LLC
- Daniel Yeager
- Teryn Daniel
- Danielle J Threatts Aprn LLC
- Anthony E Daniels
- Donavan Daniels
All providers in Lafayette, LA · Obstetrics & Gynecology 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 Jun 20, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.