Organization
LOUISIANA CARDIOVASCULAR ASSOCIATES AMPC DBA LOUISIANA HEART ASSOCIATE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLADYS T BUSH (CLINIC MANAGER)
(318) 424-2192
Entity
Organization
Contact information
Practice address
1801 FAIRFIELD AVE STE 105, SHREVEPORT, LA 71101-4457
(318) 424-2192
(318) 424-2595
Mailing address
1801 FAIRFIELD AVE STE 105, SHREVEPORT, LA 71101-4457
(318) 424-2192
(318) 424-2595
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1441414
—
LA
01
—
CH5824
RRMC
LA
Enumeration date
02/06/2007
Last updated
01/15/2010
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