Healing Grace Internal Medicine & Pediatrics, Llc
LBN: Healing Grace Internal Medicine & Pediatrics, Llc
Healing Grace Internal Medicine & Pediatrics, Llc is an health care organization with primary practice located at 6821 Pines Rd Suite 200, Shreveport LA 71129-2547. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Allergy & Immunology, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Allergy & Immunology is the primary health care specialty.
Healing Grace Internal Medicine & Pediatrics, Llc can be contacted via phone (318) 671-9309, or through Clayton, Tonya via phone (318) 671-9309.
Contact Information
Primary practice address
6821 Pines Rd Suite 200
Shreveport LA 71129-2547
Phone: (318) 671-9309
Fax: (318) 671-9311
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Allergy & Immunology | 207K00000X | 023335 | Louisiana |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 023335 | Louisiana |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 023335 | Louisiana |
Profile Details
| NPI number | 1780802504 |
|---|---|
| LBN Legal business name | Healing Grace Internal Medicine & Pediatrics, Llc |
| DBA Doing business as | |
| Authorized official | Clayton, Tonya Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Apr 24th, 2007 |
| Last updated | Aug 22nd, 2020 - about 5 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780802504 | NPPES |
| Louisiana | MEDICAID | 1494046 |
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