Individual
FLORA PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
243 CURTISS RD STE 100, BARKSDALE AFB, LA 71110-2425
(318) 456-6555
Mailing address
243 CURTISS RD STE 100, BARKSDALE AFB, LA 71110-2425
(318) 456-6555
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
W0978
TX
Other
Enumeration date
04/13/2022
Last updated
09/04/2025
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