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General NPI Number Information
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NPI Number | 1538654306
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Entity Type | Organization
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Legal Business Name | MASRI GROUP LLC
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Dates
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Enumeration Date | 06/25/2018
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Last Update Date | 03/10/2023
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Provider Practice Location Address
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Address Line | 3801 CRESWELL AVE UNIT 19
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City | SHREVEPORT
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State | LA
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Zip | 71106-1257
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Country | US
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Telephone | 734-233-4071
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Fax |
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Provider Business Mailing Address
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Address Line | 3801 CRESWELL AVE UNIT 19
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City | SHREVEPORT
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State | LA
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Zip | 71106-1257
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KAMAL MASRI
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Credential |
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Telephone | 734-233-4071
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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