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THE ASTHMA ALLERGY CLINIC NPI 1306906730


NPI Information

NPI: 1306906730
Provider Name: THE ASTHMA ALLERGY CLINIC
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
1717 E BERT KOUNS INDUSTRIAL LOOP
SUITE B
SHREVEPORT, LA
ZIP 71105
Phone: (318) 221-3584
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THE ASTHMA ALLERGY CLINIC is a specialist in Shreveport, LA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. THE ASTHMA ALLERGY CLINIC NPI is 1306906730. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1717 E BERT KOUNS INDUSTRIAL LOOP
SUITE B
SHREVEPORT, LA
ZIP 71105-561
Phone: (318) 221-3584
Fax: (318) 227-9094

The provider's authorized official is Peter Bryan Boggs .
The authorized official title is Owner and has the following contact phone number (318) 221-3584.

The enumeration date for this NPI number is 12/8/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialistMD 009735LOUISIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11122475MEDICAIDLOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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