Abdul Damra

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

S-1158 Issued in LA

Practice address

1501 Kings Hwy
Shreveport, LA 71103-4228

Phone

(318) 626-0547

NPI assigned

Jul 6, 2023

Last updated

Jul 6, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1688601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1457039810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-626-0547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-626-0547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMRA",
        "first_name": "ABDUL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-06",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "LA",
            "license": "S-1158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dale P McGinty, MD and Willis-Knighton Medical Center
• Theodore Dallas
• Wandria Coleman Dallas, APRN
• Reese Addison Dalton
• Damita Braswell
• Dana George NP and Willis-Knighton Medical Center
• Shilpa Raman Danagara
• Arissa Danford
• Heather Lee Danford
• Daniella Phuong-Di Dang, M.D.

• Student in an Organized Health Care Education/Training Program in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Student in an Organized Health Care Education/Training Program in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.