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General NPI Number Information
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NPI Number | 1649374786
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Entity Type | Individual
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Provider Name | SUBHASHINI YATURU MD
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Gender | Female
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Dates
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Enumeration Date | 09/11/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | OVERTON BROOKS VA MEDICAL CENTER
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City | SHREVEPORT
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State | LA
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Zip | 71101
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Country | US
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Telephone | 318-424-6076
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Fax | 318-424-6179
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Provider Business Mailing Address
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Address Line | 2834 LONG LAKE DRIVE
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City | SHREVEPORT
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State | LA
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Zip | 71101
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Country | US
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Telephone | 318-797-9720
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Fax | 318-424-6179
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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 | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 11466R
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License Number State | LA
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