| Leticia Alves Antunes, | |
|
7551 Youree Dr Ste 11, Shreveport, LA 71105-5533 | |
| (318) 642-9282 | |
| (833) 749-0340 |
| Full Name | Leticia Alves Antunes |
|---|---|
| Gender | Female |
| Speciality | Family Medicine |
| Location | 7551 Youree Dr Ste 11, Shreveport, Louisiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740835644 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 332691 (Louisiana) | Primary |
| Entity Name | Lsu Health Sciences Center Shreveport Faculty Group Practice |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013374222 PECOS PAC ID: 4082902721 Enrollment ID: O20161012000307 |
| Entity Name | Centerwell Senior Primary Care La Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760005136 PECOS PAC ID: 1951712280 Enrollment ID: O20210217000212 |
| Mailing Address | Practice Location Address |
|---|---|
| Leticia Alves Antunes, 6101 Blue Lagoon Dr Ste 200, Miami, FL 33126-3168 Ph: (844) 630-0700 | Leticia Alves Antunes, 7551 Youree Dr Ste 11, Shreveport, LA 71105-5533 Ph: (318) 642-9282 |
Ratnam Baby Nagalla, M.D Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 870 Olive St, Shreveport, LA 71104 Phone: 318-629-0480 Fax: 318-629-0483 | |
David Juston Colvin, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 8383 Millicent Way, Shreveport, LA 71115 Phone: 318-797-6661 Fax: 318-795-8512 | |
Susan Michelle Self, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 8001 Youree Dr, Suite 540, Shreveport, LA 71115 Phone: 318-212-3810 Fax: 318-212-3815 | |
Jaya R Mcsharma, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 700 Texas St Ste 101, Shreveport, LA 71101 Phone: 318-777-6843 Fax: 318-625-5520 | |
Dr. Kirk Anthony Grantham, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2530 Bert Kouns Loop, Suite 138, Shreveport, LA 71118 Phone: 318-588-4726 Fax: 318-900-7828 | |
Ammar Husan, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1541 Kings Hwy, Shreveport, LA 71103 Phone: 318-626-0000 | |
Dr. Jode Jann Burgin, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 9220 Ellerbe Rd, Suite 700, Shreveport, LA 71106 Phone: 318-681-5282 Fax: 318-681-5284 |