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

Southern Pediatric Clinic

Organization Primary Care Clinic/Center · NPI 1528432440

Southern Pediatric Clinic is a Primary Care 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 1
Shreveport, LA 71107-6539
Phone: (318) 221-0277
Show map & directions

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

Specialties & licences

Primary Care Clinic/Center (primary) Taxonomy 261QP2300X · Licence MD12866R (LA)

Record details

NPI number1528432440
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Stella Immanuel — Owner · (318) 730-9760
Other names Southern Pediatric Clinic
NPI enumeratedNovember 16, 2015
Last updated in NPPESNovember 16, 2015
Mailing address202 N Thomas Dr, Suite 1, Shreveport, LA 71107-6539

Other providers in Shreveport