Healthcare Provider Details

I. General information

NPI: 1376457101
Provider Name (Legal Business Name): LOUIS L SVOBODA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 N WEBB RD STE 3
GRAND ISLAND NE
68803-4041
US

IV. Provider business mailing address

1822 W 10TH ST
HASTINGS NE
68901-3617
US

V. Phone/Fax

Practice location:
  • Phone: 308-381-2036
  • Fax:
Mailing address:
  • Phone: 402-984-8987
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License NumberH12539499
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: