Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 8784 | LA |
NPI | 1033112339 |
---|---|
Provider Name | Donald E Texada |
First Address | Shreveport, LA 71106-7229 |
Second Address | Shreveport, LA 71106-7229 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2005 |
Last Update Date | 23/02/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
182771695 | RAILROAD MEDICARE PROV (01) | LA |
B60461 | (02) | LA |