George Michael Bakowski, O.D.
Optometrist in Shreveport, LA. Individual provider (NPI-1).
NPI number1679876023
StatusActive
Last updated in NPPESMay 15, 2021
Details
- NPI
- 1679876023
- Entity type
- Individual (NPI-1)
- Name
- George Michael Bakowski
- Credential
- O.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Dec 7, 2010
- Certification date
- Apr 22, 2021
- Last updated
- May 15, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 738-359T | LA | Yes |
| 152W00000X | Optometrist | 4061T | TX | |
| 152W00000X | Optometrist | 2245 | AR |
Practice location
5802 Gilbert DrShreveport, LA 71106-2226
Phone 318-347-2670
Mailing address
5802 Gilbert DrShreveport, LA 71106-2226
Phone 318-347-2670
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