Individual
DR. KYLE DEVON ANDRUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
8889 JEWELLA AVE STE C&D, SHREVEPORT, LA 71118-2138
(318) 686-5227
(318) 716-3376
Mailing address
8889 JEWELLA AVE STE C&D, SHREVEPORT, LA 71118-2138
(318) 686-5227
(318) 716-3376
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1929-865AT
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002502007
—
NV
Enumeration date
06/17/2006
Last updated
04/19/2021
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