Highland Clinic, a Prof Med Corp

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

HIGHLAND CLINIC, A PROF MED CORP

Practice address

471 Ashley Ridge Blvd
Shreveport, LA 71106-7229

Phone

(318) 795-4770

Fax

(318) 795-4775

NPI assigned

Oct 22, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Michael Gustavson

Title

Administrator

Phone

(318) 798-4465

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1445472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780358400000",
    "number": "1477925063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 E BERT KOUN LOOP",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055634",
            "telephone_number": "318-798-4500",
            "fax_number": "318-798-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "471 ASHLEY RIDGE BLVD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711067229",
            "telephone_number": "318-795-4770",
            "fax_number": "318-795-4775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHLAND CLINIC, A PROF MED CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-22",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A",
        "authorized_official_last_name": "GUSTAVSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "318-798-4465",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1038300",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Higher Dimension, Inc.
• Higher Dimension, Inc.
• Highland Clinic Optical Shop, LLC
• Highland Clinic Pharmacy, LLC
• Highland Clinic, a Prof Med Corp
• Highland Clinic, a Prof Med Corp
• Highland Clinic, a Prof Med Corp
• Highland Clinic, a Prof Med Corp
• Highland Emergency Group, LLC
• Highland Wellness Center, LLC

• Ophthalmology Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Ophthalmology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2026; 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.