Harris Memorial Pediatric & Family Clinic
Point of Service in Shreveport, LA. Organization (NPI-2).
NPI number1619353802
StatusActive
Last updated in NPPESAug 10, 2015
Details
- NPI
- 1619353802
- Entity type
- Organization (NPI-2)
- Legal business name
- Harris Memorial Pediatric & Family Clinic
- Organization subpart
- No
- Enumeration date
- Aug 10, 2015
- Last updated
- Aug 10, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 305S00000X | Point of Service | – | – | Yes |
Practice location
4571 N Market StShreveport, LA 71107-2917
Phone 318-934-0097 · Fax 318-934-0097
Mailing address
Po Box 7312Shreveport, LA 71137-7312
Phone 318-205-4075 · Fax 318-754-4134
Authorized official
Richard L Jackson
Cheif Executive Office
3182054075
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