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NPI 1003393539

IndividualActive

Alexis Broussard, OD

NPI 1003393539 · Optometrist · Columbia, SC

Provider details

NPI number: 1003393539
Entity type: Individual
Primary specialty: OptometristEye and Vision Services Providers
Credential: OD
Sex: Female
Sole proprietor: No
License: 2085 (SC)

Practice location

280 Harbison Blvd Ste T

Columbia, SC 29212-2247

Phone: (803) 732-9200

More SC providers

Mailing address

8704 Southampton Dr

Miramar, FL 33025-2716

Registry dates

Enumerated: 2018-07-26
Last updated: 2018-07-26

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Alexis Broussard, OD — NPI 1003393539, Columbia, SC | NPI Central