Provider Demographics
NPI:1124275250
Name:BRYAN A. LEBEAN, SR., M.D., APMC
Entity type:Organization
Organization Name:BRYAN A. LEBEAN, SR., M.D., APMC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:LEBEAN
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:337-261-0559
Mailing Address - Street 1:2930 MOSS STREET
Mailing Address - Street 2:SUITE B
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70501-1242
Mailing Address - Country:US
Mailing Address - Phone:337-261-0559
Mailing Address - Fax:337-769-7145
Practice Address - Street 1:1310 S UNION ST
Practice Address - Street 2:SUITE B
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570-5612
Practice Address - Country:US
Practice Address - Phone:337-942-3491
Practice Address - Fax:337-769-7145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-20
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA022124173F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173F00000XOther Service ProvidersSleep Specialist, PhDGroup - Single Specialty