NPI 1003125055

Tate James Perque, PAC

Practitioner Physician Assistant Shreveport, LA

Practice location

Address: 1453 E Bert Kouns Industrial Loop STE 318, Shreveport, LA 71105-6810
Phone: (318) 681-1968
Fax: (318) 681-1969
Mailing address: 2900 Saint Michael Dr STE 401, Texarkana, TX 75503-5211

Registered specialties (2)

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence PA200387 (LA)

Other Physician Assistant providers in Louisiana →

Surgical Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363AS0400X Licence PA.200387 (LA)

Registry record

NPI: 1003125055
Entity type: Individual
Sex (as registered): Male
NPI issued: 24 Sep 2010
Record last updated: 28 Jul 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.