Healthcare Provider Details

I. General information

NPI: 1750561114
Provider Name (Legal Business Name): MAJDI DAWUD D.C., CRT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2007
Last Update Date: 02/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9235 MANSFIELD RD
SHREVEPORT LA
71118-3124
US

IV. Provider business mailing address

9235 MANSFIELD RD
SHREVEPORT LA
71118-3124
US

V. Phone/Fax

Practice location:
  • Phone: 318-688-2234
  • Fax: 318-688-2243
Mailing address:
  • Phone: 318-688-2234
  • Fax: 318-688-2243

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License NumberLT3700
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1462
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: