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General NPI Number Information
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NPI Number | 1700525813
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Entity Type | Organization
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Legal Business Name | KINGS HEALTHCARE CLINICS LLC
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Dates
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Enumeration Date | 05/27/2022
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Last Update Date | 06/03/2022
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Provider Practice Location Address
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Address Line | 3102 LINWOOD AVE
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City | SHREVEPORT
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State | LA
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Zip | 71103-4231
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Country | US
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Telephone | 318-749-2476
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Fax |
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Provider Business Mailing Address
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Address Line | 21175 TOMBALL PKWY STE 504
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City | HOUSTON
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State | TX
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Zip | 77070-1655
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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 | AHMED SHUJA
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Credential |
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Telephone | 469-257-3500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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