Bryan Vekovius M.D. LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

LO 23263 Issued in LA

Legal business name

BRYAN VEKOVIUS M.D. LLC

Practice address

450 Ashley Ridge Blvd
Shreveport, LA 71106

Phone

(318) 675-3733

Fax

(318) 675-3734

NPI assigned

Jul 11, 2007

Organization subpart

No

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

Authorized official

Name

Bryan Johannes Vekovius, M.D.NPI 1285674820

Title

Doctor

Phone

(318) 675-3733

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bryan Johannes Vekovius, M.D.

  • Specialist
  • Shreveport, LA
  • NPI 1285674820

  Ophthalmology

  Medicare reassignment NPD Authorized official
• Pamela Elaine Theriot, O.D.

  • Optometrist
  • Shreveport, LA
  • NPI 1194823336
  Medicare reassignment NPD

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535673600000",
    "number": "1700085727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 ASHLEY RIDGE BLVD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711067228",
            "telephone_number": "318-675-3733",
            "fax_number": "318-675-3734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 ASHLEY RIDGE BLVD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71106",
            "telephone_number": "318-675-3733",
            "fax_number": "318-675-3734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRYAN VEKOVIUS M.D. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-11",
        "last_updated": "2018-08-31",
        "status": "A",
        "authorized_official_last_name": "VEKOVIUS",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "JOHANNES",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "318-675-3733",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "LA",
            "license": "LO 23263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDAL NPI#",
            "identifier": "1285674820",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Niharika Brungi
• Ashley Brunious, LCSW
• Gracyn Bruno
• Todd S. Bruno, MD
• Jessica Bruti
• Anne B Bryan, MD
• David D Bryan, MD
• Elizabeth Anne Bryan
• Gregory W Bryan, DPM
• Ashley Bryant

• 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 Aug 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.