TREY M HAROLD


Address: 1500 Line Avenue, Suite 100, Shreveport, LA 71101-4639
Phone: 3186353052

TREY M HAROLD (NPI# 1659503613) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1659503613
Entity Type Individual
Full Name TREY M HAROLD
Credential PA
Practice Address 1500 Line Avenue
Suite 100
Shreveport
LA 71101-4639
Mailing Address 1534 Elizabeth Ave Ste 301
Shreveport
LA 71101-4531
Practice Telephone 3186353052
Practice Fax Number 3186353072
Mailing Telephone 3186295001
Mailing Fax Number 3186295020
Enumeration Date 2009-08-10
Last Update Date 2020-07-31
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363A00000X Physician Assistant 200316 LA Physician Assistants & Advanced Practice Nursing Providers
N 363A00000X Physician Assistant LA Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
LA RR P00906263 01

Provider Secondary Practice Location

Address Telephone Number Fax Number
2005 Landry Dr, Bossier City, LA 711113169 3187527850 3187527855

Office Location

Street Address 1500 LINE AVENUE
SUITE 100
City SHREVEPORT
State LA
Zip Code 71101-4639

Providers in the same location

NPI Name Taxonomy Address Enumeration
1295739001 William L Overdyke Orthopaedic Surgery 1500 Line Avenue, Suite 100, Shreveport, LA 71101 2005-06-09
1790196657 Specialists Hospital Shreveport Pharmacy 1500 Line Avenue, Suite 206, Shreveport, LA 71101 2014-05-14
1417189465 Clay Eric Morgan Physician Assistant 1500 Line Avenue, Ste 100, Shreveport, LA 71101-4639 2009-08-10
1104057694 Specialists Hospital Shreveport, LLC Prosthetic/Orthotic Supplier 1500 Line Avenue, Suite 206, Shreveport, LA 71101-4639 2009-07-31
1598891491 Stephen Michael Brandao Jr. Nurse Practitioner 1500 Line Avenue, Ste 200, Shreveport, LA 71101 2007-02-26
1992831895 Joseph Michael Angelo Physician Assistant 1500 Line Avenue, Ste 100, Shreveport, LA 71101 2007-02-26
1891821583 Chris D Howard Nurse Practitioner 1500 Line Avenue, Ste 200, Shreveport, LA 71101 2007-02-26
1255470118 John David Googe Orthopaedic Surgery 1500 Line Avenue, Ste 100, Shreveport, LA 71101 2007-02-06
1346393816 Michele Allison Occupational Therapist 1500 Line Avenue, Ste 100, Shreveport, LA 71101 2007-01-19
1073585477 Philip Andrew Utter Neurological Surgery 1500 Line Avenue, Ste 200, Shreveport, LA 71101 2006-02-02
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1255988630 Renee Jewitt Case Manager/Care Coordinator 1513 Line Avenue, Suite 225, Shreveport, LA 71101 2019-08-21
1942770094 Bessie Larry Case Manager/Care Coordinator 1513 Line Av, 222, Shreveport, LA 71101 2018-12-03
1750875944 Jarvis Decarleonne Larry Community Health Worker 1513 Line Ave # 222, Shreveport, LA 71101 2018-06-20
1871083485 Kimberly B. Mcclelland, Lcsw Counselor 820 Jordan St. Ste 510w, Shreveport, LA 71101 2018-05-18
1982106456 Hudson Amc LLC Internal Medicine 1800 Irving Place, Shreveport, LA 71101 2018-03-01
1528572955 Spencer Ron Floyd Counselor 1717 Marshall Street, Shreveport, LA 71101 2017-11-21
1578088076 Brittany Morris Case Manager/Care Coordinator 1835 Spring Street Annex Building, Shreveport, LA 71101 2017-08-07
1275058794 Diane Williams Case Manager/Care Coordinator 217 Jones St Apt 510, Shreveport, LA 71101 2017-08-04
1386195972 Jakeya Woodbury Counselor 453 Stoner Ave, Shreveport, LA 71101 2016-10-18
1922459643 Arlene Huling Counselor 449 Egan Street, Shreveport, LA 71101 2016-06-23
Find all providers in zip 71101

Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1740829217 Bno Surgical Consultants, LLC Physician Assistant 303 Captain Hm Shreve Blvd, Shreveport, LA 71115 2020-01-02
1497394076 Midday Surgical Consultants, LLC Physician Assistant 550 Linden St, Shreveport, LA 71104-4426 2019-12-31
1225677800 Geaux Surgical Consultants, LLC Physician Assistant 370 Gallier Pl, Shreveport, LA 71106-8377 2019-12-31
1962041541 Ace Surgical Consultants, LLC Physician Assistant 11045 Gabriels Path, Shreveport, LA 71106-7791 2019-12-31
1013499763 Kristi Harrison Gaspard Physician Assistant 2508 Bert Koun Loop Ste 106, Shreveport, LA 71118-3175 2018-08-29
1295216125 Heather White Physician Assistant 745 Olive St Ste 200, Shreveport, LA 71104-2246 2018-08-28
1285143669 Kara Forbis Physician Assistant 2600 Kings Hwy Ste 420, Shreveport, LA 71103-3950 2017-09-28
1144748195 Catherine Murphy Rogers Physician Assistant 2727 Hearne Ave Ste 300, Shreveport, LA 71103-3918 2017-08-30
1972955474 Robin Egan Physician Assistant 1811 E Bert Koun Loop Ste 200, Shreveport, LA 71105-5766 2016-07-07
1457733198 Brfhh Shreveport LLC Physician Assistant 1541 Kings Highway, Shreveport, LA 71103-4228 2015-06-18
Find all providers in SHREVEPORT

Competitor

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City SHREVEPORT
Zip Code 71101

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Dataset Information

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.

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