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Individual

HIRAM VAZQUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3217 MABEL ST, SHREVEPORT, LA 71103-4022
(318) 631-9121
(318) 631-9126
Mailing address
3217 MABEL ST, SHREVEPORT, LA 71103-4022
(318) 631-9121
(318) 631-9126

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
07162R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1382426
LA
Enumeration date
01/16/2006
Last updated
07/29/2011
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