Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Shane T Broussard, PA

Individual provider Physician Assistant · NPI 1164468435

Shane T Broussard, PA is a Physician Assistant in Lafayette, Louisiana. Licensed in Louisiana. Registered with an NPI since 2006.

Licensed in
LA
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

1103 Kaliste Saloom Rd Ste 102
Lafayette, LA 70508-2920
Phone: (337) 234-5234
Fax: (337) 235-2121
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence A10272 (LA)

Record details

NPI number1164468435
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJune 22, 2006
Last updated in NPPESFebruary 3, 2009

Other providers in Lafayette