# ARKLATEX TBI, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427703768
- **Authorized official:** DR. RANDY DWAYNE BRYN MD (CMO)
- **Authorized official phone:** (318) 393-2322

## Contact information

- **Practice address:** 900 PIERREMONT RD STE 110, SHREVEPORT, LA 71106-2055
- **Practice address phone:** (318) 455-2127
- **Mailing address:** 10904 DAUPHINE ST STE 110, SHREVEPORT, LA 71106-8531
- **Mailing address phone:** (318) 455-2127

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 02/15/2022
- **Last updated:** 02/15/2022