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General NPI Number Information
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NPI Number | 1376760728
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Entity Type | Organization
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Legal Business Name | D & G HOLDINGS, LLC
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 11/07/2007
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Provider Practice Location Address
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Address Line | 8516 STODDARD ST
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City | PLEASANT HILL
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State | LA
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Zip | 71065-4607
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Country | US
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Telephone | 318-796-3894
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Fax | 318-796-2104
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Provider Business Mailing Address
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Address Line | PO BOX 7161
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City | SHREVEPORT
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State | LA
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Zip | 71137-7161
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Country | US
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Telephone | 318-390-7611
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Fax | 318-949-5123
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Authorized Official
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Title or Position | ACCOUNT MANAGER
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Name | MS. TRACIE T UNDERWOOD
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Credential |
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Telephone | 318-390-7611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State | LA
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