Provider Demographics
NPI:1659303857
Name:ROMAGUERA, PEDRO N (MD)
Entity Type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:N
Last Name:ROMAGUERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 HOUMA BLVD STE 501
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2927
Mailing Address - Country:US
Mailing Address - Phone:504-779-3507
Mailing Address - Fax:504-779-3508
Practice Address - Street 1:3901 HOUMA BLVD STE 501
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2927
Practice Address - Country:US
Practice Address - Phone:504-779-3507
Practice Address - Fax:504-779-3508
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.09148R207R00000X
LA09148R207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1932523Medicaid
LAF42145Medicare UPIN
LA1932523Medicaid