Provider Demographics
NPI:1639465065
Name:LURAGUIZ, NATALIA
Entity Type:Individual
Prefix:DR
First Name:NATALIA
Middle Name:
Last Name:LURAGUIZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1534 ELIZABETH AVE STE 401
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101-4531
Mailing Address - Country:US
Mailing Address - Phone:318-431-8613
Mailing Address - Fax:318-314-2203
Practice Address - Street 1:1534 ELIZABETH AVE STE 401A
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101-4531
Practice Address - Country:US
Practice Address - Phone:318-431-8613
Practice Address - Fax:318-314-2203
Is Sole Proprietor?:No
Enumeration Date:2011-06-23
Last Update Date:2023-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP9640208D00000X
LAMD.208257207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice