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Individual

ANTONIO O BURNS SR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
401 SENECA TRL, SHREVEPORT, LA 71107-5461
(318) 977-0911
Mailing address
401 SENECA TRL, SHREVEPORT, LA 71107-5461
(318) 977-0911

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
43238060
TX

Other

Enumeration date
10/17/2022
Last updated
04/29/2026
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