Healthcare Provider Details

I. General information

NPI: 1033044573
Provider Name (Legal Business Name): DR. SARAVANAN NATESAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 07/18/2026
Certification Date: 07/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2727 HEARNE AVE STE 320
SHREVEPORT LA
71103-3917
US

IV. Provider business mailing address

2600 GREENWOOD RD
SHREVEPORT LA
71103-3908
US

V. Phone/Fax

Practice location:
  • Phone: 318-212-6797
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number352659
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: