Most Relevant Information
Provider Data
| NPI Number: | 1003434267 |
| Provider Name: | JAMES DALE BROUSSARD |
| Entity Type: | Individual |
| Taxonomy Code: | 246ZC0007X |
| Specialty: | Specialist/Technologist, Other |
| License Number: | 187328 |
Most Important Dates
| Enumeration Date: | 07/13/2020 |
| Last Updated: | 07/13/2020 |
Provider Practice Location
7324 SOUTHWEST FWY STE 1550
HOUSTON
TX
770742053
Practice Location Phone/Fax
| Phone: | 7137799800 |
| Fax: |
Provider Mailing Location
7324 SOUTHWEST FWY STE 1550
HOUSTON
TX
770742053
Provider Mailing Phone/Fax
| Phone: | 7137799800 |
| Fax: |