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General NPI Number Information
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NPI Number | 1629920798
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Entity Type | Individual
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Provider Name | THOMAS JASON MCCREA DC
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Gender | Male
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Dates
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Enumeration Date | 02/11/2026
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Last Update Date | 02/11/2026
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Provider Practice Location Address
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Address Line | 1005 SOUTHLAND PARK DR
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City | SHREVEPORT
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State | LA
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Zip | 71118-3218
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Country | US
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Telephone | 318-688-1221
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Fax |
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Provider Business Mailing Address
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Address Line | 215 GOOD TIMES LN
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City | FRIERSON
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State | LA
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Zip | 71027-2145
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Country | US
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Telephone | 318-402-9203
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2067
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License Number State | LA
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