NPIMap

Organization Active NPI

Endovascular Technologies, LLC

  • Interventional Cardiology Physician
  • Bossier City, LA
National Provider Identifier
1902138498
Registry record updated Feb 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
021588 Issued in LA
Legal business name
ENDOVASCULAR TECHNOLOGIES, LLC
Practice address
2300 Hospital Dr
Suite 450
Bossier City, LA 71111-2394
Phone
(318) 752-2328
Fax
(318) 746-0160
NPI assigned
Feb 8, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2010

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

Authorized official

Name
William Britton Eaves II, M.D.
Title
Owner
Phone
(318) 752-2328

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0011X 021588 LA Primary

Addresses

Primary practice location

2300 Hospital Dr
Suite 450
Bossier City, LA 71111-2394

Mailing address

PO Box 1760
Shreveport, LA 71166-1760
Phone (318) 752-2328

National Provider Directory

National Provider Directory

Locations

2300 Hospital Dr
Ste 450
Bossier City, LA 71111
Phone (318) 425-4096

NPI Registry JSON

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

{
    "created_epoch": "1265587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265587200000",
    "number": "1902138498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1760",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711661760",
            "telephone_number": "318-752-2328",
            "fax_number": "318-746-0160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 HOSPITAL DR",
            "address_2": "SUITE 450",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112394",
            "telephone_number": "318-752-2328",
            "fax_number": "318-746-0160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDOVASCULAR TECHNOLOGIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-08",
        "last_updated": "2010-02-08",
        "status": "A",
        "authorized_official_last_name": "EAVES",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "BRITTON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-752-2328",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "LA",
            "license": "021588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bossier City, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2010; 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.