Individual
OCTAVIO DE JESUS AREVALO ESPEJO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0000
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
(318) 626-0287
(318) 629-4808
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
327970
LA
2085R0202X
Diagnostic Radiology Physician
U9819
TX
Other
Enumeration date
05/01/2018
Last updated
12/10/2025
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