Healthcare Provider Details

I. General information

NPI: 1992709745
Provider Name (Legal Business Name): ALAN B RICHARDS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2005
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 WATERS EDGE DR
SHREVEPORT LA
71106-7774
US

IV. Provider business mailing address

112 WATERS EDGE DR
SHREVEPORT LA
71106-7774
US

V. Phone/Fax

Practice location:
  • Phone: 318-455-5569
  • Fax:
Mailing address:
  • Phone: 318-455-5569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number05012R
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code207WX0110X
TaxonomyPediatric Ophthalmology and Strabismus Specialist Physician Physician
License NumberMD.05012R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: