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BROUSSARD FAMILY PRACTICE, PLLC
NPI 1710320908
Specialist in Beaumont, TX

Active since April 08, 2013CLIA 45D2066878 · Waiver
810 HOSPITAL DR STE 100, BEAUMONT, TX 77701(409) 833-0342 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 21, 2022, Mar 17, 2018, Jun 21, 2017 (3 updates tracked since 2017).

About Broussard Family Practice, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BROUSSARD FAMILY PRACTICE, PLLC (NPI 1710320908) is a healthcare organization registered as a specialist in Beaumont, Texas and active in the NPI registry since April 2013. The organization holds a CLIA Waiver certificate valid through October 3, 2027, maintains a secondary practice location in Beaumont, and lists Juliette Rose Broussard, Family Nurse Practitioner/owner, as its authorized official.

NPPES Registry Identity

NPI1710320908
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameBROUSSARD FAMILY PRACTICE, PLLC
Location Address810 HOSPITAL DR STE 100Beaumont, TX 77701-4633
Mailing AddressPo Box 7096Beaumont, TX 77726-7096 · (409) 833-0342 · Fax (877) 770-4091
Phone(409) 833-0342
Organization SubpartNo
Authorized OfficialJuliette Rose BroussardFamily Nurse Practitioner/owner · (409) 833-0342
Enumeration DateApril 8, 2013
Last NPPES UpdateJuly 21, 20223 updates tracked since enumeration
✔ NPI 1710320908 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in TX · L2891
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 651610 (TX)
810 HOSPITAL DR STE 100, Beaumont, TX 77701
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Secondary Practice Location 1

Location 17675 Folsom Dr Ste 300BBeaumont, TX 77706-7299 · Phone (409) 833-0342 · Fax (877) 770-4091

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2066878

Broussard Family Practice, PLLC · Beaumont, TX
Active · expires Oct 3, 2027
CLIA Number45D2066878
Laboratory TypeLaser
Certificate Effective DateOctober 4, 2025
Certificate Expiration DateOctober 3, 2027
Laboratory DirectorJuliette Broussard
Laboratory Phone(409) 833-0342
Laboratory LocationBroussard Family Practice, PLLC7675 Folsom Drive Ste 300B, Beaumont, TX 77706
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Broussard Family Practice, PLLC's NPI number?

The NPI number for Broussard Family Practice, PLLC is 1710320908. It was assigned to this organization in the NPPES registry on April 8, 2013.

Where is Broussard Family Practice, PLLC located?

Broussard Family Practice, PLLC is located at 810 Hospital Dr Ste 100, Beaumont, TX 77701. The listed phone number is (409) 833-0342.

What is Broussard Family Practice, PLLC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Does Broussard Family Practice, PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2066878) is associated with this NPI, valid through October 3, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Broussard Family Practice, PLLC was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.