Provider Demographics
NPI:1891719597
Name:CUARTAS, PEDRO JOSE (DDS)
Entity Type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:JOSE
Last Name:CUARTAS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 VALHI BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-5976
Mailing Address - Country:US
Mailing Address - Phone:985-872-3677
Mailing Address - Fax:985-872-3680
Practice Address - Street 1:600 VALHI BLVD
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360
Practice Address - Country:US
Practice Address - Phone:985-872-3677
Practice Address - Fax:985-872-3680
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5237122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA680560746OtherTAX-ID