# WILSON B. BABER MD LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ark-La-Tex Retina Consultants, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023143518
- **Authorized official:** DR. WILSON BLOOMFIELD BABER M.D. (OWNER)
- **Authorized official phone:** (318) 221-3403

## Contact information

- **Practice address:** 1455 E BERT KOUN LOOP STE 207, SHREVEPORT, LA 71105-5634
- **Practice address phone:** (318) 221-3403
- **Practice address fax:** (318) 221-6744
- **Mailing address:** PO BOX 44309, SHREVEPORT, LA 71134-4309
- **Mailing address phone:** (318) 221-3403
- **Mailing address fax:** (318) 221-6744

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 021943 | LA | Yes |

## Other

- **Enumeration date:** 02/23/2007
- **Last updated:** 02/07/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1179851 | — | LA |
| 05 | — | 195783901 | — | TX |