Organization
ARK-LA-TEX CHILDRENS CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS LATIOLAIS MD (PARTNER)
(318) 742-6710
Entity
Organization
Contact information
Practice address
2400 HOSPITAL DR, STE 120, BOSSIER CITY, LA 71111-2386
(318) 742-6710
(318) 747-5393
Mailing address
2400 HOSPITAL DR, STE 120, BOSSIER CITY, LA 71111-2386
(318) 742-6710
(318) 747-5393
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0404240
LA
Other
Enumeration date
06/27/2005
Last updated
06/12/2008
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