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General NPI Number Information
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NPI Number | 1700981792
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Entity Type | Organization
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Legal Business Name | SHAHID MANSOOR MD, APMC
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 10/25/2007
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Provider Practice Location Address
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Address Line | 501 MEDICAL CENTER DR STE 3A
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City | ALEXANDRIA
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State | LA
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Zip | 71301-8124
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Country | US
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Telephone | 318-484-3899
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Fax | 318-484-3887
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Provider Business Mailing Address
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Address Line | 501 MEDICAL CENTER DR STE 3A
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City | ALEXANDRIA
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State | LA
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Zip | 71301-8124
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Country | US
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Telephone | 318-484-3899
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Fax | 318-484-3887
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | DR. SHAHID MANSOOR
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Credential | MD
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Telephone | 318-484-3899
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 13654R
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License Number State | LA
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