Individual
HORACIO RUBEN D'AGOSTINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1501 KINGS HWY, DEPARTMENT OF RADIOLOGY, SHREVEPORT, LA 71103-4228
(318) 675-7737
(318) 675-5666
Mailing address
1501 KINGS HWY, DEPARTMENT OF RADIOLOGY, SHREVEPORT, LA 71103-4228
(318) 675-7737
(318) 675-5666
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
13200R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1555134
—
LA
Enumeration date
07/15/2006
Last updated
07/08/2007
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