Southern Pediatric Clinic
Southern Pediatric Clinic is a Health Service Clinic/Center in Shreveport, Louisiana. Licensed in Louisiana. Registered with an NPI since 2015.
- Licensed in
- LA
- In the registry since
- 2015
Practice location Address checks out
202 N Thomas Dr Ste 1Shreveport, LA 71107-6539
Phone: (318) 221-0277
Fax: (318) 221-3277
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Health Service Clinic/Center (primary) | Taxonomy 261QH0100X · Licence MD12866R (LA) |
|---|
Record details
| NPI number | 1104297720 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Stella Immanuel — Owner · (318) 221-0277 |
| NPI enumerated | October 8, 2015 |
| Last updated in NPPES | November 3, 2015 |
| Mailing address | 202 N Thomas Dr, Suite 1, Shreveport, LA 71107-6539 |
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