Rayfus J Broussard, DDS Inc

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

11407 Issued in TX

Legal business name

RAYFUS J BROUSSARD, DDS INC

Practice address

1120 Longfellow Dr
Beaumont, TX 77706-4845

Phone

(409) 898-7847

NPI assigned

Jan 25, 2012

Last updated

Jan 25, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Rayfus J Broussard, D.D.S.NPI 1487752887

Title

Orthodontist

Phone

(409) 898-7847

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Rayfus Joseph Broussard, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Beaumont, TX
  • NPI 1487752887
  NPD (past) Authorized official

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

{
    "created_epoch": "1327449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327449600000",
    "number": "1669743498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 LONGFELLOW DR",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777064845",
            "telephone_number": "409-898-7847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 LONGFELLOW DR",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777064845",
            "telephone_number": "409-898-7847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAYFUS J BROUSSARD, DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-25",
        "last_updated": "2012-01-25",
        "status": "A",
        "authorized_official_last_name": "BROUSSARD",
        "authorized_official_first_name": "RAYFUS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ORTHODONTIST",
        "authorized_official_telephone_number": "409-898-7847",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "11407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164122701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ravi Halaswamy MD PA
• Ravikumar Kanneganti MD Kanneganti Counseling Services
• Ravikumar Kanneganti MD PA
• Linda J Ray, MD
• Lisa Ray, M.S., CCC-SLP
• RCB Medical PLLC
• Kaitlyn Read
• Travis E Read, MSN
• Heather Nicole Reading, AU.D.
• Real Life Healthcare, LLC

• Orthodontics and Dentofacial Orthopedics Dentistry in Beaumont, TX
• Providers in Beaumont, TX by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.