Pediatric Providers of Louisiana
Pediatric Providers of Louisiana is a Health Service Clinic/Center in Shreveport, Louisiana. Licensed in Louisiana. Registered with an NPI since 2009.
- Licensed in
- LA
- In the registry since
- 2009
Practice location Address checks out
4140 Hollywood AveShreveport, LA 71109-7818
Phone: (318) 621-9600
Fax: (318) 621-0169
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Health Service Clinic/Center (primary) | Taxonomy 261QH0100X · Licence 06203R (LA) |
|---|
Record details
| NPI number | 1548494578 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Jean Rousseau — President · (318) 621-9600 |
| Other names | Mooretown Family Clinic |
| NPI enumerated | May 5, 2009 |
| Last updated in NPPES | August 21, 2009 |
| Mailing address | 4140 Hollywood Ave, Shreveport, LA 71109-7818 |
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