Provider Demographics
NPI:1184667685
Name:VIVES, MARIA TERE (MD)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:TERE
Last Name:VIVES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:200 HENRY CLAY AVE
Mailing Address - Street 2:SUITE 3317
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70118-5720
Mailing Address - Country:US
Mailing Address - Phone:504-896-2134
Mailing Address - Fax:504-896-2135
Practice Address - Street 1:200 HENRY CLAY AVE
Practice Address - Street 2:SUITE 3317
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118-5720
Practice Address - Country:US
Practice Address - Phone:504-896-2134
Practice Address - Fax:504-896-2135
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA10138R207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1431818Medicaid
LAG668883Medicare UPIN
LA5H524D520Medicare ID - Type Unspecified