Individual
MARY CATHERINE MANCINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1453 E BERT KOUNS INDUSTRIAL LOOP STE 319, SHREVEPORT, LA 71105-6800
(318) 681-1968
(318) 681-1969
Mailing address
919 HIDDEN RDG, IRVING, TX 75038-3813
(469) 282-2713
(469) 282-0996
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD.08695R
LA
2086S0102X
Surgical Critical Care Physician
MD.08695R
LA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
08695R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1914801
—
LA
Enumeration date
07/25/2006
Last updated
11/16/2017
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