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Organization

DEEPIKA RALLA MD LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DEEPIKA REDDY RALLA MD (MEMBER MANAGER)
(201) 455-6383
Entity
Organization

Contact information

Practice address
2525 VIKING DR, BOSSIER CITY, LA 71111-2103
(318) 841-2525
Mailing address
PO BOX 1684, SHREVEPORT, LA 71165-1684
(318) 424-4008
(855) 230-1466

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Enumeration date
11/16/2018
Last updated
11/16/2018
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