NPIMap

Organization Active NPI

Ark-la-Tex Childrens Clinic LLC

  • Pediatrics Physician
  • Bossier City, LA
National Provider Identifier
1962408781
Registry record updated Jun 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0404240 Issued in LA
Legal business name
ARK-LA-TEX CHILDRENS CLINIC LLC
Practice address
2400 Hospital Dr
Ste 120
Bossier City, LA 71111-2386
Phone
(318) 742-6710
Fax
(318) 747-5393
NPI assigned
Jun 27, 2005
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Dr. Thomas Latiolais, MDNPI 1679578116
Title
Partner
Phone
(318) 742-6710

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Practitioners 10

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

National Provider Directory

National Provider Directory

Locations

2400 Hospital Dr
Ste 120
Bossier City, LA 71111
Phone (318) 742-6710

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 0404240 LA Primary

Addresses

NPPES NPI Registry

Primary practice location

2400 Hospital Dr
Ste 120
Bossier City, LA 71111-2386

Mailing address

2400 Hospital Dr
Ste 120
Bossier City, LA 71111-2386
Phone (318) 742-6710

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 12, 2008.

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213228800000",
    "number": "1962408781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 HOSPITAL DR",
            "address_2": "STE 120",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112386",
            "telephone_number": "318-742-6710",
            "fax_number": "318-747-5393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 HOSPITAL DR",
            "address_2": "STE 120",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112386",
            "telephone_number": "318-742-6710",
            "fax_number": "318-747-5393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARK-LA-TEX CHILDRENS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-27",
        "last_updated": "2008-06-12",
        "status": "A",
        "authorized_official_last_name": "LATIOLAIS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "318-742-6710",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "0404240",
            "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 Jun 12, 2008; 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.