Abaka LLC
Internal Medicine in Shreveport, LA. Organization (NPI-2).
NPI number1477106524
StatusActive
Last updated in NPPESJul 18, 2019
Details
- NPI
- 1477106524
- Entity type
- Organization (NPI-2)
- Legal business name
- Abaka LLC
- Organization subpart
- No
- Enumeration date
- Jul 18, 2019
- Last updated
- Jul 18, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | – | – | Yes |
| 207Q00000X | Family Medicine | – | – |
Practice location
3050 Baird RdShreveport, LA 71118-3818
Phone 318-688-1010
Mailing address
Po Box 1684Shreveport, LA 71165-1684
Phone 318-424-4008 · Fax 855-230-1466
Authorized official
Allan Matriano Lim
Member
3185880880
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