Provider Demographics
NPI:1891763694
Name:LINARES, LUIS A (MD)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:A
Last Name:LINARES
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 1:4204 HOUMA BLVD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2903
Mailing Address - Country:US
Mailing Address - Phone:504-454-1727
Mailing Address - Fax:504-455-4857
Practice Address - Street 1:4204 HOUMA BLVD
Practice Address - Street 2:SUITE 211
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2903
Practice Address - Country:US
Practice Address - Phone:504-454-1727
Practice Address - Fax:504-455-4857
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10119R2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1990833Medicaid
LAB17672Medicare UPIN
LA1990833Medicaid