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General NPI Number Information
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NPI Number | 1417979915
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Entity Type | Individual
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Provider Name | SHAUL DAVID AUSTIN LPC
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Gender | Male
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Dates
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Enumeration Date | 07/24/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | LSU FAMILY MEDICINE CLINIC- BOGALUSA 420 AVENUE F
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City | BOGALUSA
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State | LA
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Zip | 70427
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Country | US
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Telephone | 985-732-0058
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Fax |
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Provider Business Mailing Address
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Address Line | 1340 POYDRAS ST
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City | NEW ORLEANS
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State | LA
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Zip | 70112-1221
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Country | US
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Telephone | 504-412-1860
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 2105
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License Number State | LA
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