Provider Demographics
NPI:1083621189
Name:LURIE, AUBREY ABRAHAM (MD)
Entity Type:Individual
Prefix:DR
First Name:AUBREY
Middle Name:ABRAHAM
Last Name:LURIE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:510 E. STONER AVE.
Mailing Address - Street 2:(113) OVERTON BROOKS VA MEDICAL CENTER
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101-6128
Mailing Address - Country:US
Mailing Address - Phone:318-424-6092
Mailing Address - Fax:318-424-6093
Practice Address - Street 1:510 E STONER AVE
Practice Address - Street 2:OVERTON BROOKS VA MED. CENTER (113)
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101-4243
Practice Address - Country:US
Practice Address - Phone:318-424-6092
Practice Address - Fax:318-424-6093
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA07934R291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory