LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER VIRAL DISEASE CLINI (NPI# 1285635540) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285635540 |
| Entity Type | Organization |
| Organization Name | LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER VIRAL DISEASE CLINI |
| Practice Address |
6670 Saint Vincent Ave Shreveport LA 71106-2638 |
| Mailing Address |
1821 Bayou Dr Shreveport LA 71105-3403 |
| Practice Telephone | 3188629986 |
| Mailing Telephone | 3188652578 |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. ROBERT PENN (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 3187985930 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | LA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1697770 | 05 |
| Street Address |
6670 SAINT VINCENT AVE |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71106-2638 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972008332 | Andrew Joseph Brouillette | Dentist | 385 Bert Kouns Industrial Loop Ste 700, Shreveport, LA 71106 | 2018-03-28 |
| 1548775885 | David Wayne Spears | Pharmacist | 10460 Norris Ferry Road, Shreveport, LA 71106 | 2017-12-08 |
| 1225559263 | Susan Anderson Roblow | Physical Therapist | 921 Unadilla Street, Shreveport, LA 71106 | 2017-06-29 |
| 1134656382 | James Lowder | Dentist | 8691 Line Ave Ste 300, Shreveport, LA 71106 | 2017-05-18 |
| 1144753708 | Laverne Brantley | Counselor | 328 E 69th St, Shreveport, LA 71106 | 2017-04-10 |
| 1437690849 | Biostat Laboratories, LLC | Clinical Medical Laboratory | 9742 Saint Vincent Ave Ste 200, Shreveport, LA 71106 | 2017-03-17 |
| 1841730728 | Cedric Thomas | Case Manager/Care Coordinator | 6811 Fairfield Avenue, Shreveport, LA 71106 | 2017-02-27 |
| 1225576192 | Nick Vergis | Pharmacist | 5828 Line Avenue, Shreveport, LA 71106 | 2017-02-10 |
| 1184162554 | Marilyn Johnson | Case Manager/Care Coordinator | 9245 Wallace Lake Rd Ste A, Shreveport, LA 71106 | 2017-02-06 |
| 1417499740 | Pamela Lee | Counselor | 8802 Coyth Ln, Shreveport, LA 71106 | 2016-11-17 |
| Find all providers in zip 71106 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104432970 | Genetics Collection LLC | Clinic/Center | 214 W 70th St Ste 205, Shreveport, LA 71106-3756 | 2020-09-17 |
| 1992219836 | Gallego Health | Clinic/Center | 115 Hallette Dr, Shreveport, LA 71115-2959 | 2017-11-30 |
| 1265772586 | Walter Asseff | Clinic/Center | 2014 Beth Ln, Shreveport, LA 71118-2708 | 2013-02-23 |
| 1861671869 | Mid-city Family Clinic, LLC | Clinic/Center | 838 Margaret Pl, Shreveport, LA 71101-4509 | 2007-10-26 |
| 1447360524 | Ross H Dies Dds and J Cody Cowen Dds A Dental LLC | Clinic/Center | 910 Bert Kouns Industrial Loop, Shreveport, LA 71118 | 2006-08-30 |
| 1679594782 | Premier Care and Learning Center, Inc | Clinic/Center | 2110 Hollywood Ave, Shreveport, LA 71108-3922 | 2006-07-22 |
| 1932181054 | The Arthritis & Rheumatology Clinic, A Medical Corporation | Clinic/Center | 740 Jordan St, Shreveport, LA 71101-4616 | 2005-11-15 |
| 1871083162 | The Healing Clinic, LLC | Clinic/Center | 745 Olive St Ste 109, Shreveport, LA 71104-2250 | 2018-05-14 |
| 1427490937 | Bombinamd LLC | Clinic/Center | 4140 Hollywood Ave, Suite B-2, Shreveport, LA 71109-7818 | 2013-07-25 |
| 1073950028 | Diabetes Assessment and Management Center of Shreveport, LLC | Clinic/Center | 1560 Irving Pl, Suite 501, Shreveport, LA 71101-4604 | 2013-05-31 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71106 |
Please comment or provide details below to improve the information on LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER VIRAL DISEASE CLINI.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.