Provider Demographics
NPI:1891052783
Name:DELAHOUSSAYE, THOMAS EDWARD
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:EDWARD
Last Name:DELAHOUSSAYE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6009 ARGONNE BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70124-3819
Mailing Address - Country:US
Mailing Address - Phone:504-232-6838
Mailing Address - Fax:
Practice Address - Street 1:6009 ARGONNE BLVD
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70124-3819
Practice Address - Country:US
Practice Address - Phone:504-232-6838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-16
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA307057208600000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program