Organization
SHREVEPORT EYE CLINIC A MEDICAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD E TEXADA MD (PRESIDENT)
(318) 861-4009
Entity
Organization
Contact information
Practice address
471 ASHLEY RIDGE BLVD, SHREVEPORT, LA 71106
(318) 861-4009
Mailing address
471 ASHLEY RIDGE BLVD, SHREVEPORT, LA 71106
(318) 861-4009
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1045578
—
LA
Enumeration date
07/10/2006
Last updated
11/28/2007
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