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General NPI Number Information
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NPI Number | 1881127090
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Entity Type | Organization
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Legal Business Name | ADVANCED CARDIOVASCULAR SPECIALISTS
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Dates
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Enumeration Date | 04/05/2017
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Last Update Date | 05/11/2017
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Provider Practice Location Address
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Address Line | 1453 E BERT KOUN LOOP STE 112
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City | SHREVEPORT
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State | LA
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Zip | 71105-6800
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Country | US
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Telephone | 318-798-9400
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 51008
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City | SHREVEPORT
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State | LA
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Zip | 71135-1008
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Country | US
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Telephone | 318-798-9400
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | THOMAS A BROWN
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Credential | M.D.
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Telephone | 318-798-9400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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