Healthcare Provider Details
I. General information
NPI: 1831066471
Provider Name (Legal Business Name): BAYOU SLEEP MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/20/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
700 TEXAS ST STE 101
SHREVEPORT LA
71101-3514
US
IV. Provider business mailing address
918 FAIRVIEW ST
SHREVEPORT LA
71104-4230
US
V. Phone/Fax
- Phone: 318-415-6710
- Fax:
- Phone: 318-415-6710
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RA0201X |
| Taxonomy | Allergy & Immunology (Internal Medicine) Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RS0012X |
| Taxonomy | Sleep Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANAND
BHAT
Title or Position: OWNER
Credential: MD
Phone: 318-415-6710