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

Dr. Jason Bourque, MD

Individual provider Urology Physician · NPI 1205060175

Dr. Jason Bourque, MD is an Urology in Lafayette, Louisiana. Graduated from Louisiana State University School of Medicine in New Orleans in 2009, 17 years ago. Practices with Southern Urology LLC, a 28-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Louisiana and Texas.

Years since qualifying
17
Trained at
Louisiana State University School of Medicine in New Orleans
Licensed in
LA, TX
In the registry since
2009
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

120 Rue Louis Xiv
Lafayette, LA 70508-5739
Phone: (337) 769-7779
Show map & directions

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

Additional practice locations (2)

  • 200 Beaullieu Dr Ste 7, Lafayette, LA 70508-7230 — (337) 233-2455
  • 2401 S 31st St, Temple, TX 76508-0001 — (254) 724-2111

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X · Licence 307858 (LA)
Urology Physician Taxonomy 208800000X · Licence 10033777 (TX)
Urology Physician Taxonomy 208800000X · Licence Q3854 (TX)

Record details

NPI number1205060175
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 7, 2009
Last updated in NPPESMarch 17, 2018
Mailing address120 Rue Louis Xiv, Lafayette, LA 70508-5739

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyUROLOGY
Medical schoolLOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS
Graduated 2009 (17 years in practice)
Group practice Southern Urology Llc — 28 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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