Thad Alexander Bourque in Lafayette - Urology
Thad Alexander Bourque - NPI 1912093709
Thad Alexander Bourque is a Urology in Lafayette, Louisiana. Thad Alexander Bourque practices all healthcare services and medical treatments related to Urology. The NPI Number for Thad Alexander Bourque is 1912093709. The last update date is 2023-03-07.
Thad Alexander Bourque's current location address is 1103 Kaliste Saloom Rd, Lafayette, Louisiana. You can contact this provider via phone number 3379881803 and fax number 3379881805. The mailing address for Thad Alexander Bourque is 1103 Kaliste Saloom Rd, Lafayette, Louisiana. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Thad Alexander Bourque |
|---|---|
| Address | 1103 Kaliste Saloom Rd, Lafayette, Louisiana |
| Phone Number | 3379881803 |
| Fax Number | 3379881805 |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1912093709 |
|---|---|
| Provider Enumeration Date | 2006-10-05 |
| Last Updated Date | 2023-03-07 |
Provider Mailing Address Detail
| Address | 1103 Kaliste Saloom Rd |
|---|---|
| City | Lafayette |
| State | Louisiana (LA) |
| Post Code | 705085783 |
| Phone Number | 3379881803 |
| Fax Number | 3379881805 |
Provider's Primary Taxonomy Detail
| Speciality | Urology |
|---|---|
| Taxonomy | 208800000X |
| Licence No | MD.021311 |
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Definition: A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquir |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| C5115 | LA | BLUE CROSS BLUE SHIELD | |
| 1680974 | LA | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Thad Alexander Bourque by the Centers for Medicare & Medicaid Services?
The Thad Alexander Bourque has been issued the NPI (National Provider Identifier) 1912093709 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please provide the complete physical location address of Thad Alexander Bourque?
The Thad Alexander Bourque is physically situated at 1103 Kaliste Saloom Rd, in the city of Lafayette, state of LA, with the postal code 705085783.
What is the area of specialization for Thad Alexander Bourque, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Thad Alexander Bourque is Urology, and the corresponding taxonomy code that categorizes this area of expertise is 208800000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1912093709 to Thad Alexander Bourque?
The Centers for Medicare & Medicaid Services originally issued the 1912093709 to Thad Alexander Bourque on 2006-10-05.
As of what date were the Thad Alexander Bourque's details last updated?
The information pertaining to the Thad Alexander Bourque, including its address, specialty, and other details, was most recently updated on 2023-03-07.
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