Provider Demographics
NPI:1730488057
Name:BORDES, BRIANNE MARIE
Entity Type:Individual
Prefix:
First Name:BRIANNE
Middle Name:MARIE
Last Name:BORDES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5710 GENERAL DIAZ ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70124-2829
Mailing Address - Country:US
Mailing Address - Phone:504-289-4464
Mailing Address - Fax:
Practice Address - Street 1:5710 GENERAL DIAZ ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70124-2829
Practice Address - Country:US
Practice Address - Phone:504-289-4464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-25
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.205681207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology