# NORTHERN LOUISIANA CARDIAC SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ADVANCED HEART AND VASCULAR CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376055897
- **Authorized official:** ISAAC PALMER (BOARD MEMBER)
- **Authorized official phone:** (318) 681-5054

## Contact information

- **Practice address:** 1453 E BERT KOUNS INDUSTRIAL LOOP STE 220, SHREVEPORT, LA 71105-6810
- **Practice address phone:** (318) 629-3170
- **Practice address fax:** (318) 629-3171
- **Mailing address:** PO BOX 51008, SHREVEPORT, LA 71135-1008
- **Mailing address phone:** (318) 629-3170

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/25/2017
- **Last updated:** 11/02/2017