Dural Bridges
Individual provider Active NPI Driver · Shreveport, LA
NPI 1508340530 · NPPES record last updated Sep 15, 2018
Key facts
- NPI
- 1508340530
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- Practice address
- 8841 Coyth LN
Shreveport, LA 71106-6346 - Phone
- (318) 207-1970
- NPI assigned
- Sep 15, 2018
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | Yes |
Addresses
Primary practice location
8841 Coyth LN
Shreveport, LA 71106-6346
Mailing address
8841 Coyth LN
Shreveport, LA 71106-6346
Phone (318) 207-1970
Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 15, 2018. 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.