Provider Demographics
NPI:1083249080
Name:HELPING OUR PATIENTS EVOLVE, LLC
Entity Type:Organization
Organization Name:HELPING OUR PATIENTS EVOLVE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:THARWAT
Authorized Official - Middle Name:
Authorized Official - Last Name:GHATTAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-716-1200
Mailing Address - Street 1:745 OLIVE ST STE 202
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71104-2246
Mailing Address - Country:US
Mailing Address - Phone:318-716-1200
Mailing Address - Fax:
Practice Address - Street 1:745 OLIVE ST STE 109
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71104-2250
Practice Address - Country:US
Practice Address - Phone:318-716-1200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-10
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder