Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 203707 | LA |
N | 207VX0201X | Gynecologic Oncologist | L8401 | TX |
NPI | 1548448442 |
---|---|
Provider Name | Robin Ann Lacour |
First Address | Shreveport, LA 71103-3950 |
Second Address | Shreveport, LA 71103-3950 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2008 |
Last Update Date | 28/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2118293 | (05) | LA |
4P174F600 | MEDICARE - PTAN (01) | LA |