Individual
MRS. SANDRA DELVALLE RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0000
(318) 629-4833
Mailing address
1666 E BERT KOUNS INDUSTRIAL LOOP, SHREVEPORT, LA 71105-5714
(318) 212-3520
(318) 212-3525
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA09380
TX
363A00000X
Physician Assistant
Primary
PA200735
LA
Other
Enumeration date
10/20/2014
Last updated
12/19/2024
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