Andre Raoul Bezou, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

013197 Issued in LA

Practice address

4227 Lakeshore Dr
Mandeville, LA 70448

Phone

(985) 892-8088

NPI assigned

Mar 8, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Andre Raoul Bezou, M.D.

  • Clinic/Center
  • Mandeville, LA
  • NPI 1235269135
  NPD (past)

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992836571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4227 LAKESHORE DR",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "70448",
            "telephone_number": "985-892-8088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4227 LAKESHORE DR",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "70448",
            "telephone_number": "985-892-8088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEZOU",
        "first_name": "ANDRE",
        "middle_name": "RAOUL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "LA",
            "license": "013197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1161179",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monette D. Bernard, LCSW
• Lisa-Maree Berube
• Beth Saacks DDS Apdc
• Beth Saacks, D.D.S. & Associates
• Beyond Wellness LLC
• Bianchini- Skaff Copeland LLC
• Bianchini-Brennan/Stabler, LLC
• Bianchini-Holcomb
• Katherine Bickham, DPT
• Marleen Billiot, LCSW

• Urology Physician in Mandeville, LA
• Providers in Mandeville, LA by specialty
• Urology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.