is a Pediatric Cardiology in Shreveport, Louisiana. practices all healthcare services and medical treatments related to Pediatric Cardiology. The NPI Number for is 1770740672. The last update date is .
's current location address is 1512 W Kirby Pl, Shreveport, Louisiana. You can contact this provider via phone number 3186756073. The mailing address for is 1512 W Kirby Pl, Shreveport, Louisiana. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 1512 W Kirby Pl, Shreveport, Louisiana |
| Phone Number | 3186756073 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1770740672 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 1512 W Kirby Pl |
|---|---|
| City | Shreveport |
| State | Louisiana (LA) |
| Post Code | 711033822 |
| Phone Number | 3186756073 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Pediatric Cardiology |
|---|---|
| Taxonomy | 2080P0202X |
| Licence No | MD.204766 |
|
Definition: A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinica |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2164473 | LA | -- | |
| 4Q419F600 | LA | MEDICARE - PTAN |
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