Organization
ARKLATEX TBI, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDY DWAYNE BRYN MD (CMO)
(318) 393-2322
Entity
Organization
Contact information
Practice address
900 PIERREMONT RD STE 110, SHREVEPORT, LA 71106-2055
(318) 455-2127
Mailing address
10904 DAUPHINE ST STE 110, SHREVEPORT, LA 71106-8531
(318) 455-2127
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
02/15/2022
Last updated
02/15/2022
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