IndividualActive
Brian Fontenot, PA-C
NPI 1790228013 · Medical Physician Assistant · Shreveport, LA
Provider details
- NPI number
- 1790228013
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- License
- 303880 (LA)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
2751 Albert L Bicknell Dr Ste 5c
Shreveport, LA 71103-3943
Phone: (318) 227-9777
Fax: (318) 459-1188
Approximate (ZIP-level) locationGet directions
Mailing address
2751 Albert L Bicknell Dr Ste 5c
Shreveport, LA 71103-3943
Additional practice locations (1)
- 6701 Fannin StHouston, TX 77030-2608Phone: (832) 824-1000
Registry dates
- Enumerated
- 2016-11-18
- Last updated
- 2021-07-12
- Certified
- 2021-07-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.