HIGHLAND CLINIC, A PROF MED CORP
NPI 1477925063
Ophthalmology in Shreveport, LA

Q: What is Highland Clinic, A Prof Med Corp's NPI number?

The NPI number for Highland Clinic, A Prof Med Corp is 1477925063. It was assigned to this organization in the NPPES registry on October 22, 2015.

Q: What is Highland Clinic, A Prof Med Corp's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Active since October 22, 2015

471 ASHLEY RIDGE BLVD, SHREVEPORT, LA 71106(318) 795-4770(318) 795-4775 Get Directions Write a Review

NPPES record last updated: June 2, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 2, 2026, Dec 8, 2015 (2 updates tracked since 2015).

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About Highland Clinic, A Prof Med Corp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HIGHLAND CLINIC, A PROF MED CORP (NPI 1477925063) is a healthcare organization registered as an ophthalmology in Shreveport, Louisiana and active in the NPI registry since October 2015. The organization lists Michael Gustavson, Administrator, as its authorized official.

NPPES Registry Identity

NPI1477925063

Entity TypeOrganization

Primary Taxonomy207W00000X

Legal Business NameHIGHLAND CLINIC, A PROF MED CORP

Location Address471 ASHLEY RIDGE BLVDShreveport, LA 71106-7229

Mailing Address1455 E Bert Koun LoopShreveport, LA 71105-5634 · (318) 798-4500 · Fax (318) 798-4555

Phone(318) 795-4770

Fax(318) 795-4775

Organization SubpartNo

Authorized OfficialMichael GustavsonAdministrator · (318) 798-4465

Enumeration DateOctober 22, 2015

Last NPPES UpdateJune 2, 20262 updates tracked since enumeration

NPPES CertifiedJune 2, 2026

✔ NPI 1477925063 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians

Taxonomy Code207W00000X

Definition

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

471 ASHLEY RIDGE BLVD, Shreveport, LA 71106

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Other Identifiers 1

Medicaid1038300LA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CLAUDE YOUNGBLOOD BUNDRICK JR. MD

Ophthalmology