1841491289 NPI number — HENRY A PRETUS MD PHD APMC

Table of content: (NPI 1841491289)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841491289 NPI number — HENRY A PRETUS MD PHD APMC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HENRY A PRETUS MD PHD APMC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841491289
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/18/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4300 HOUMA BLVD
Provider Second Line Business Mailing Address:
SUITE 303
Provider Business Mailing Address City Name:
METAIRIE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70006-2932
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-207-2222
Provider Business Mailing Address Fax Number:
504-846-3002

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1057 PAUL MAILLARD RD
Provider Second Line Business Practice Location Address:
SUITE 210
Provider Business Practice Location Address City Name:
LULING
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70070-4349
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
985-785-5610
Provider Business Practice Location Address Fax Number:
504-846-3002
Provider Enumeration Date:
05/31/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PRETUS
Authorized Official First Name:
HENRY
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
504-207-2222

Provider Taxonomy Codes

  • Taxonomy code: 2086S0129X , with the licence number:  MD.10849R , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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