Individual
ENRIQUE JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 221-8411
Mailing address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 221-8411
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
MD.14048R
LA
207RI0011X
Interventional Cardiology Physician
Primary
MD.14048R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1041360
—
LA
Enumeration date
08/01/2006
Last updated
09/12/2023
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