Trent Matthew Andre
Individual provider Active NPI Physical Therapist · Shreveport, LA
NPI 1053966192 · NPPES record last updated Aug 6, 2019
Key facts
- NPI
- 1053966192
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 10255 (LA)
- Practice address
- 460 Ashley Ridge Blvd Ste 800
Shreveport, LA 71106-7238 - Phone
- (318) 868-6172
- NPI assigned
- Aug 6, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Core Physical Therapy and Performance, LLC | Physical Therapist | Current |
Accepting new patients |
Locations
460 Ashley Ridge Blvd
Ste 800
Shreveport, LA 71106
Phone (318) 868-6172
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 10255 | LA | Yes |
Addresses
Primary practice location
460 Ashley Ridge Blvd Ste 800
Shreveport, LA 71106-7238
Mailing address
460 Ashley Ridge Blvd Ste 800
Shreveport, LA 71106-7238
Phone (318) 868-6172
Other providers in Shreveport, LA
- Stephanie Anderson
- Tenasija Rashad Anderson
- Tina Maria Anderson
- Tracy Jerome Anderson
- Lincoln Andre
- Michelle Andres
- William Andress
- Andrew Dentino MD and Willis-Knighton Medical Center
- Andrew Oyoung MD and Willis-Knighton Medical Center
- Andrew Simpson, DDS, LLC
All providers in Shreveport, LA · Physical Therapist in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 6, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.