Provider Demographics
NPI:1669010203
Name:ASBURY, DAVID RYAN (PLPC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:RYAN
Last Name:ASBURY
Suffix:
Gender:M
Credentials:PLPC
Other - Prefix:MR
Other - First Name:DAVID
Other - Middle Name:RYAN
Other - Last Name:ASBURY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA-PLPC
Mailing Address - Street 1:1605 MURRAY ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-6890
Mailing Address - Country:US
Mailing Address - Phone:318-443-9035
Mailing Address - Fax:318-443-9037
Practice Address - Street 1:710 VERSAILLES BLVD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-2351
Practice Address - Country:US
Practice Address - Phone:318-787-6749
Practice Address - Fax:318-787-6804
Is Sole Proprietor?:No
Enumeration Date:2019-12-13
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPLC8062171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator