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General NPI Number Information
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NPI Number | 1740214774
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Entity Type | Organization
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Legal Business Name | DRDHR INC
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 11/02/2011
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Provider Practice Location Address
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Address Line | 7330 FERN AVE SUITE 702
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City | SHREVEPORT
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State | LA
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Zip | 71105-4971
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Country | US
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Telephone | 318-798-6699
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Fax |
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Provider Business Mailing Address
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Address Line | 7330 FERN AVE SUITE 702
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City | SHREVEPORT
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State | LA
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Zip | 71105-4971
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Country | US
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Telephone | 318-798-6699
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID HONGWEI REN
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Credential | M.D., PH.D
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Telephone | 318-798-6699
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 14570R
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License Number State | LA
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