Individual
NISAR AHMED I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1501 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0434
(318) 626-0434
Mailing address
1501 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 441-1030
(318) 626-0434
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
348163
LA
Other
Enumeration date
09/04/2025
Last updated
09/04/2025
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