| Masri Group LLC | |
|
3801 Creswell Ave Unit 19 Shreveport LA 71106-1257 | |
| (734) 233-4071 | |
| Not Available |
| Full Name | Masri Group LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 3801 Creswell Ave Unit 19, Shreveport, Louisiana |
| Authorized Official Name and Position | Kamal Masri (OWNER) |
| Authorized Official Contact | 7342334071 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Masri Group LLC 3801 Creswell Ave Unit 19 Shreveport LA 71106-1257 | Masri Group LLC 3801 Creswell Ave Unit 19 Shreveport LA 71106-1257 Ph: (734) 233-4071 |
| NPI Number | 1538654306 |
|---|---|
| Provider Enumeration Date | 06/25/2018 |
| Last Update Date | 03/10/2023 |
| Certification Date | 03/10/2023 |
| Medicare PECOS PAC ID | 8527316652 |
|---|---|
| Medicare Enrollment ID | O20180807001559 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538654306 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Secondary |
| 207RC0200X | Internal Medicine - Critical Care Medicine | () | Primary |
| Provider Name | Kamal a Masri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134418437 PECOS PAC ID: 8022232305 Enrollment ID: I20150129001319 |
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