# ABAKA LLC

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

## Provider details

- **NPI number:** 1477106524
- **Authorized official:** ALLAN MATRIANO LIM MD (MEMBER)
- **Authorized official phone:** (318) 588-0880

## Contact information

- **Practice address:** 3050 BAIRD RD, SHREVEPORT, LA 71118-3818
- **Practice address phone:** (318) 688-1010
- **Mailing address:** PO BOX 1684, SHREVEPORT, LA 71165-1684
- **Mailing address phone:** (318) 424-4008
- **Mailing address fax:** (855) 230-1466

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/18/2019
- **Last updated:** 07/18/2019