Active NPI
Lydia Barham Oswalt
- Pharmacist
- Shreveport, LA
National Provider Identifier
1265722607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11694
- Practice address
- 3810 Jewella Ave
Shreveport, LA 71109-4706 - Phone
- (318) 631-9010
- NPI assigned
- Apr 18, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 11694 | LA | Primary |
Addresses
Primary practice location
3810 Jewella Ave
Shreveport, LA 71109-4706
Mailing address
2010 Pine Ridge Way
Benton, LA 71006-3488
Phone (318) 965-4173
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11694 | LA | MD | Case Manager/Care Coordinator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303084800000",
"number": "1265722607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2010 PINE RIDGE WAY",
"city": "BENTON",
"state": "LA",
"postal_code": "710063488",
"telephone_number": "318-965-4173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3810 JEWELLA AVE",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711094706",
"telephone_number": "318-631-9010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OSWALT",
"first_name": "LYDIA",
"middle_name": "BARHAM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-04-18",
"last_updated": "2011-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "11694",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.