Individual
BAOGANG XUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1501 KINGS HWY, DEPARTMENT OF PSYCHIATRY, SHREVEPORT, LA 71103-4228
(318) 675-5000
Mailing address
1501 KINGS HWY, DEPARTMENT OF PSYCHIATRY, SHREVEPORT, LA 71103-4228
(318) 675-5000
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD438584
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07081
—
LA
Enumeration date
12/17/2007
Last updated
06/09/2010
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