Mohammad Ansari

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Shreveport, LA

NPI 1497423974 · NPPES record last updated Aug 31, 2021

Key facts

NPI
1497423974
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
1501 Kings Hwy
Shreveport, LA 71103-4228
Phone
(318) 626-0434
NPI assigned
Aug 31, 2021
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

1501 Kings Hwy
Shreveport, LA 71103-4228

Mailing address

1501 Kings Hwy
Shreveport, LA 71103-4228
Phone (318) 626-0434

Other providers in Shreveport, LA

All providers in Shreveport, LA · Student in an Organized Health Care Education/Training Program in Louisiana

Sources for this page

Verify at the official NPI Registry.