Individual
WALLY R NAWAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2300 HOSPITAL DRIVE, SUITE 140, BOSSIER CITY, LA 71111-2157
(318) 746-2020
(318) 741-3508
Mailing address
2300 HOSPITAL DRIVE, SUITE 140, BOSSIER CITY, LA 71111-2157
(318) 746-2020
(318) 741-3508
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
024997
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1423351
—
LA
05
—
1423551
—
LA
Enumeration date
03/15/2006
Last updated
09/20/2012
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