{
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"FirstLineMailingAddress": "1541 KINGS HWY",
"SecondLineMailingAddress": "ATTN: PHARMACY RM AG-13",
"MailingAddressCityName": "SHREVEPORT",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "318-626-0863",
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"FirstLinePracticeLocationAddress": "1606 KINGS HWY RM 2263",
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"PracticeLocationAddressTelephoneNumber": "318-626-0454",
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"EnumerationDate": "10/07/2014",
"LastUpdateDate": "03/17/2025",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LAFITTE",
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"AuthorizedOfficialTelephoneNumber": "318-560-7698",
"Taxonomies": {
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}