Provider Demographics
NPI:1316614365
Name:BEKTESHI, DEA (OD)
Entity type:Individual
Prefix:
First Name:DEA
Middle Name:
Last Name:BEKTESHI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:DEA
Other - Middle Name:
Other - Last Name:ORANA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:1455 E BERT KOUNS INDUSTRIAL LOOP
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-5634
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:471 ASHLEY RIDGE BLVD
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71106-7229
Practice Address - Country:US
Practice Address - Phone:318-795-4770
Practice Address - Fax:318-795-4775
Is Sole Proprietor?:No
Enumeration Date:2021-08-26
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1949-885AT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist