Provider Demographics
NPI:1346503307
Name:LOUKA, BOSHRA F (MBBCH)
Entity Type:Individual
Prefix:DR
First Name:BOSHRA
Middle Name:F
Last Name:LOUKA
Suffix:
Gender:M
Credentials:MBBCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2727 HEARNE AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71103-3918
Mailing Address - Country:US
Mailing Address - Phone:318-631-6400
Mailing Address - Fax:318-631-0300
Practice Address - Street 1:2727 HEARNE AVE STE 301
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71103
Practice Address - Country:US
Practice Address - Phone:318-631-6400
Practice Address - Fax:318-631-0300
Is Sole Proprietor?:No
Enumeration Date:2012-06-24
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ50235207RC0000X, 207RI0011X
390200000X
LA320467207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program