HomeNPI Verification

NPI Verification

National Provider Identifier: 1912093709

Thad Alexander Bourque, M.d.

Individual Provider

Credentials

M.D.

Primary Specialty

Urology

Code: 208800000X

All Specialties (2)

Specialist

Code: 174400000X

Urology

Code: 208800000X

Primary

Practice Address

1103 KALISTE SALOOM RD

SUITE 200

LAFAYETTE, LA 705085783

Phone: 337-988-1803

NPI Enumeration Date

October 5, 2006

NPI Number

1912093709

Data sourced from the official CMS NPPES Registry. This information is provided by the Centers for Medicare & Medicaid Services and is updated regularly.

View on CMS NPPES Registry