| David Hurtado De Mendoza, Md Llc | |
|
1541 Kings Hwy # 10th Shreveport LA 71103-4228 | |
| (318) 688-8504 | |
| Not Available |
| Full Name | David Hurtado De Mendoza, Md Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1541 Kings Hwy # 10th, Shreveport, Louisiana |
| Authorized Official Name and Position | David M Hurtado (MANAGER) |
| Authorized Official Contact | 7862802908 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| David Hurtado De Mendoza, Md Llc 5667 Mirador Cir Shreveport LA 71119-4009 Ph: () - | David Hurtado De Mendoza, Md Llc 1541 Kings Hwy # 10th Shreveport LA 71103-4228 Ph: (318) 688-8504 |
| NPI Number | 1891556361 |
|---|---|
| Provider Enumeration Date | 01/22/2024 |
| Last Update Date | 01/22/2024 |
| Medicare PECOS PAC ID | 8527404417 |
|---|---|
| Medicare Enrollment ID | O20240314000456 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891556361 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | David Marshall Hurtado De Mendoza Paz |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1528599388 PECOS PAC ID: 0648698621 Enrollment ID: I20200909000485 |
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