Healthcare Provider Details
I. General information
NPI: 1245211978
Provider Name (Legal Business Name): MARY CATHERINE ARANDA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/09/2005
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2032 ELIZABETH AVE
SHREVEPORT LA
71104-2123
US
IV. Provider business mailing address
2032 ELIZABETH AVE
SHREVEPORT LA
71104-2123
US
V. Phone/Fax
- Phone: 318-698-0035
- Fax: 318-698-0078
- Phone: 318-698-0035
- Fax: 318-698-0078
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0006X |
| Taxonomy | Developmental - Behavioral Pediatrics Physician |
| License Number | MD.206564 |
| License Number State | LA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: