Andrus, Kyle Devon
Andrus, Kyle Devon is an sole proprietor health care provider with primary practice located at 8889 Jewella Ave Ste C&D , Shreveport LA 71118-2138. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Andrus, Kyle Devon can be contacted via phone (318) 686-5227.Contact Information
Primary practice address
8889 Jewella Ave Ste C&D
Shreveport LA 71118-2138
Phone: (318) 686-5227
Fax: (318) 716-3376
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1929-865AT | Louisiana |
Profile Details
| NPI number | 1316982028 |
|---|---|
| LBN Legal business name | Andrus, Kyle Devon |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 17th, 2006 |
| Last updated | Apr 19th, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316982028 | NPPES |
| Nevada | MEDICAID | 002502007 |
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