Organization
BRFHH SHREVEPORT LLC
Active
Other names
UNIVERSITY HEALTH SHREVEPORT
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VERNON MOORE (CFO)
(318) 675-4864
Entity
Organization
Contact information
Practice address
1541 KINGS HIGHWAY, SHREVEPORT, LA 71103-4228
(318) 675-7636
(318) 675-7531
Mailing address
1541 KINGS HIGHWAY, SHREVEPORT, LA 71103-4228
(318) 675-7636
(318) 675-7531
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/18/2015
Last updated
08/24/2017
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