Provider Demographics
NPI:1497720379
Name:HENRY A. PRETUS, M.D., PHD, APMC
Entity Type:Organization
Organization Name:HENRY A. PRETUS, M.D., PHD, APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:PRETUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-207-2222
Mailing Address - Street 1:1937 VETERANS MEMORIAL BLVD # 306
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-2656
Mailing Address - Country:US
Mailing Address - Phone:504-207-2222
Mailing Address - Fax:
Practice Address - Street 1:4300 HOUMA BLVD
Practice Address - Street 2:SUITE 303
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2932
Practice Address - Country:US
Practice Address - Phone:504-207-2222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-22
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5CX45Medicare PIN
CJ7705Medicare PIN