Individual
DR. TERRY WAYNE KENDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1549 E 70TH ST, STE 300, SHREVEPORT, LA 71105-5053
(318) 681-4896
(318) 681-4897
Mailing address
919 HIDDEN RDG, IRVING, TX 75038-3813
(469) 282-2711
(469) 282-0996
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
017838
LA
208000000X
Pediatrics Physician
Primary
MD.017838
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1371793
—
LA
Enumeration date
01/05/2006
Last updated
01/24/2017
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