Healthcare Provider Details

I. General information

NPI: 1609918945
Provider Name (Legal Business Name): RUDOLPH W. TROUP JR. OD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 12/21/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8889 JEWELLA AVE SUITE D
SHREVEPORT LA
71118-2138
US

IV. Provider business mailing address

8889 JEWELLA AVE. STE. E
SHREVEPORT LA
71118-2138
US

V. Phone/Fax

Practice location:
  • Phone: 318-686-5227
  • Fax: 318-686-5242
Mailing address:
  • Phone: 318-686-5227
  • Fax: 318-686-5283

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number725-178T
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: