Provider Demographics
NPI:1710266077
Name:THAPA, TRISHNA (MD)
Entity Type:Individual
Prefix:
First Name:TRISHNA
Middle Name:
Last Name:THAPA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:130 DESIARD ST
Mailing Address - Street 2:SUITE 355
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-7319
Mailing Address - Country:US
Mailing Address - Phone:318-807-7875
Mailing Address - Fax:318-812-6603
Practice Address - Street 1:2408 BROADMOOR BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-2963
Practice Address - Country:US
Practice Address - Phone:318-807-0525
Practice Address - Fax:318-807-1077
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-04
Last Update Date:2015-04-23
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Provider Licenses
StateLicense IDTaxonomies
LA207188207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2157574Medicaid
LA366678YJBUMedicare PIN