Provider Demographics
NPI:1528514221
Name:VICTORIA HEALTHCARE RESOURCES
Entity type:Organization
Organization Name:VICTORIA HEALTHCARE RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:ASHLYE
Authorized Official - Middle Name:
Authorized Official - Last Name:LINDSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-698-3250
Mailing Address - Street 1:9441 STEVENS RD
Mailing Address - Street 2:SUITE 100-B
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71106-7567
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2300 WEST SECOND STREET
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:LA
Practice Address - Zip Code:71065
Practice Address - Country:US
Practice Address - Phone:318-796-3896
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory