MEDICARE: ARKLATEX MEDICAL CONSULTANTS A MEDICAL CORPORATION

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207LP2900X	Pain Medicine (Anesthesiology) Physician
2	261QP2000X	Physical Therapy Clinic/Center
3	261QM1300X	Multi-Specialty Clinic/Center
4	363A00000X	Physician Assistant
5	208VP0014X	Interventional Pain Medicine Physician

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2646045	OTHER	WELLCARE
3	10376054	OTHER	MULTIPLAN
4	86589315	OTHER	VANTAGE
5	3979188	OTHER	CIGNA
6	628764900	OTHER	OWCP
7	7039847	OTHER	UNITED HEALTHCARE

NPI Number	:	1710466628
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARKLATEX MEDICAL CONSULTANTS A MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	8731 PARK PLAZA DR
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71105-5682
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8731 PARK PLAZA DR
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71105-5682
Country	:	US
Telephone Number	:	318-797-5848
Fax Number	:	318-797-5844

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	NICOLE YOAKUM
Credential	:
Telephone Number	:	318-918-9859

Provider Enumeration Date	:	08/10/2018
Last Update Date	:	01/19/2026

8731 PARK PLAZA DR STE B
SHREVEPORT, LA
71105-5682

Practice Phone: 318-797-5848
Practice Fax:

8731 PARK PLAZA DR
SHREVEPORT, LA
71105-5682