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

Clifford Allen Revoredo

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1962259879

Clifford Allen Revoredo is a Student in an Organized Health Care Education/Training Program in Shreveport, Louisiana. Practices as a sole proprietor. Registered with an NPI since 2024.

In the registry since
2024

Practice location Address checks out

1501 Kings Hwy
Shreveport, LA 71103-4228
Phone: (318) 626-0555
Show map & directions

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

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1962259879
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 30, 2024
Last updated in NPPESApril 30, 2024
Certification dateApril 30, 2024

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