Holliway Pediatric Clinic

LBN: Holliway Medical Clinic Llc
Holliway Pediatric Clinic is an health care organization with primary practice located at 3824 Hearne Ave , Shreveport LA 71103. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as the primary health care specialty. Holliway Medical Clinic Llc can be contacted via phone (318) 635-8606, or through Holliway, Brondwyn Ann via phone (318) 635-8606.

Contact Information

Primary practice address
3824 Hearne Ave Shreveport LA 71103
Fax: (318) 635-1265
Website:
Authorized official contact:
Name: Holliway, Brondwyn Ann Doctor of Medicine (MD)

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 021100 Louisiana

Profile Details

NPI number 1891833869
LBN Legal business name Holliway Medical Clinic Llc
DBA Doing business as Holliway Pediatric Clinic
Authorized official Holliway, Brondwyn Ann Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Feb 2nd, 2007
Last updated Aug 22nd, 2020 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891833869 NPPES
Louisiana MEDICAID 1966207
Louisiana Other 1449423

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