Healthcare Provider Details

I. General information

NPI: 1497745921
Provider Name (Legal Business Name): ARK-LA-TEX CARDIOLOGY, APMC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2005
Last Update Date: 12/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2727 HEARNE AVE SUITE 300
SHREVEPORT LA
71103-3917
US

IV. Provider business mailing address

PO BOX 51008
SHREVEPORT LA
71135-1008
US

V. Phone/Fax

Practice location:
  • Phone: 318-798-9400
  • Fax: 318-798-3894
Mailing address:
  • Phone: 318-798-9400
  • Fax: 318-798-3894

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. THOMAS ALAN BROWN
Title or Position: PRESIDENT/MANAGING PHYSICIAN
Credential: M.D.
Phone: 318-798-9400