SURGICAL SPECIALTY CENTER LLC NPI 1316970916

NPI Information

  • NPI: 1316970916
  • Provider Name: SURGICAL SPECIALTY CENTER, LLC
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • Address: 1500 LINE AVE
    SUITE 204
    SHREVEPORT, LA
    ZIP 71101
  • Phone: (318) 629-5001

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NPI Details

SURGICAL SPECIALTY CENTER, LLC is an ambulatory surgical clinic center in Shreveport, LA. SURGICAL SPECIALTY CENTER, LLC NPI is 1316970916. The provider is registered as an organization entity type.

The provider's business location address is:

1500 LINE AVE
SUITE 204
SHREVEPORT, LA
ZIP 71101-639
Phone: (318) 629-5001
Fax: (318) 629-5020

The provider's authorized official is Kandi R Moore .
The authorized official title is Administrator and has the following contact phone number (318) 631-2525.

The enumeration date for this NPI number is 7/8/2006 and was last updated on 3/31/2008.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QA1903XClinic/CenterAmbulatory Surgical80LOUISIANAYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
111066MEDICARE ID-TYPE UNSPECIFIEDLOUISIANA
21478334MEDICAIDLOUISIANA

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: 11/21/2025

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