Dr. Kyle Devon Andrus, O.D.
Optometrist in Shreveport, LA. Individual provider (NPI-1).
NPI number1316982028
StatusActive
Last updated in NPPESApr 19, 2021
Details
- NPI
- 1316982028
- Entity type
- Individual (NPI-1)
- Name
- Dr. Kyle Devon Andrus
- Credential
- O.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 17, 2006
- Certification date
- Apr 19, 2021
- Last updated
- Apr 19, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 1929-865AT | LA | Yes |
Practice location
8889 Jewella Ave Ste C&DShreveport, LA 71118-2138
Phone 318-686-5227 · Fax 318-716-3376
Mailing address
8889 Jewella Ave Ste C&DShreveport, LA 71118-2138
Phone 318-686-5227 · Fax 318-716-3376
Other practice locations
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