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

Wk Pines Road Family Medicine

Organization Family Medicine Physician · NPI 1629210042

Wk Pines Road Family Medicine is a Family Medicine Physician in Shreveport, Louisiana. Registered with an NPI since 2009.

In the registry since
2009

Practice location Address checks out

9111 Susan Dr
Shreveport, LA 71118-3136
Phone: (318) 212-5969
Fax: (318) 212-5979
Show map & directions

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

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1629210042
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mary Ward — Sr Vp Finance · (318) 716-4939
NPI enumeratedMarch 31, 2009
Last updated in NPPESMarch 5, 2026
Certification dateMarch 5, 2026
Mailing address9111 Susan Dr, Shreveport, LA 71118-3136

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