Provider Demographics
NPI:1740214774
Name:DRDHR INC
Entity Type:Organization
Organization Name:DRDHR INC
Other - Org Name:REGIONAL RETINA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:HONGWEI
Authorized Official - Last Name:REN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:318-798-6699
Mailing Address - Street 1:7330 FERN AVE
Mailing Address - Street 2:SUITE 702
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-4971
Mailing Address - Country:US
Mailing Address - Phone:318-798-6699
Mailing Address - Fax:
Practice Address - Street 1:7330 FERN AVE
Practice Address - Street 2:SUITE 702
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-4971
Practice Address - Country:US
Practice Address - Phone:318-798-6699
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA14570R207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty