Provider Demographics
NPI:1770670341
Name:ESTARIS, RAUL BUADA (MD)
Entity Type:Individual
Prefix:DR
First Name:RAUL
Middle Name:BUADA
Last Name:ESTARIS
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 1:3321 FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-3680
Mailing Address - Country:US
Mailing Address - Phone:504-465-0800
Mailing Address - Fax:504-461-8516
Practice Address - Street 1:3321 FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065-3680
Practice Address - Country:US
Practice Address - Phone:504-465-0800
Practice Address - Fax:504-461-8516
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2022-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME69709207R00000X
LA07332R207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1372064Medicaid
LA1372064Medicaid
53860Medicare ID - Type Unspecified