Medical school: LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN SHREVEPORT
Graduated: 1988
NPI: 1235131665
Practice Locations (1)
COUNCIL FOR ADVANCEMENT OF SOCIAL SERVICE AND EDUCATION
2120 BERT KOUNS INDUSTRIAL LOOP
SHREVEPORT, LA 711183351
31868833501230
Source: CMS National Downloadable File, September 2026.