Organization
ABAKA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALLAN MATRIANO LIM MD (MEMBER)
(318) 588-0880
Entity
Organization
Contact information
Practice address
3050 BAIRD RD, SHREVEPORT, LA 71118-3818
(318) 688-1010
Mailing address
PO BOX 1684, SHREVEPORT, LA 71165-1684
(318) 424-4008
(855) 230-1466
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
07/18/2019
Last updated
07/18/2019
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