# DIABETIC CARE CENTERS OF LOUISIANA INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Diabetic Care Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174238752
- **Authorized official:** MICHAEL SHANE DAVIDSON (OWNER/MANAGER)
- **Authorized official phone:** (318) 512-1176

## Contact information

- **Practice address:** 7659 GILBERT ST., SUITE D, GILBERT, LA 71336
- **Practice address phone:** (318) 657-1220
- **Practice address fax:** (318) 367-1376
- **Mailing address:** 7659 GILBERT ST., SUITE D, GILBERT, LA 71336-3427

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/18/2023
- **Last updated:** 06/21/2023