Individual provider · Type 1 NPI

Mary Alexis K. Green, PA-C

Physician Assistant · Shreveport, LA

NPI number 1366436487 Active

Practice location

1455 E Bert Kouns Industrial Loop Ste 210
Shreveport, LA 71105-6000

Call (318) 798-4623 Map

Fax (318) 798-4569

Mailing address

1455 E Bert Kouns Loop
Shreveport, LA 71105-5634

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000XPA.200024 (LA)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1366436487

Mary Alexis K. Green, PA-C's National Provider Identifier is 1366436487, issued on Sep 2, 2005. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Shreveport, LA. The record was last updated on Feb 2, 2026.