Organization
BRYAN VEKOVIUS M.D. LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN JOHANNES VEKOVIUS M.D. (DOCTOR)
(318) 675-3733
Entity
Organization
Contact information
Practice address
450 ASHLEY RIDGE BLVD, SHREVEPORT, LA 71106
(318) 675-3733
(318) 675-3734
Mailing address
450 ASHLEY RIDGE BLVD, SHREVEPORT, LA 71106-7228
(318) 675-3733
(318) 675-3734
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
LO 23263
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1285674820
INDIVIDAL NPI#
LA
Enumeration date
07/11/2007
Last updated
08/31/2018
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