Provider Demographics
NPI:1013982974
Name:MCLAREN, RHETT F (MD)
Entity Type:Individual
Prefix:
First Name:RHETT
Middle Name:F
Last Name:MCLAREN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 HOSPITAL DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-2394
Mailing Address - Country:US
Mailing Address - Phone:318-212-7883
Mailing Address - Fax:318-212-7885
Practice Address - Street 1:2200 ROY RICHARD DR
Practice Address - Street 2:
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78154-2723
Practice Address - Country:US
Practice Address - Phone:210-566-4777
Practice Address - Fax:210-566-4779
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS7916208000000X
LA14634R208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1134333Medicaid
LA1134333Medicaid