Provider Demographics
NPI:1982661997
Name:PRETUS, HENRY A (MD)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:A
Last Name:PRETUS
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 1:4300 HOUMA BLVD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2925
Mailing Address - Country:US
Mailing Address - Phone:504-207-2222
Mailing Address - Fax:
Practice Address - Street 1:4300 HOUMA BLVD
Practice Address - Street 2:SUITE 303
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2925
Practice Address - Country:US
Practice Address - Phone:504-207-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10849R2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1497622Medicaid
LAH18627Medicare UPIN
5H410CX45Medicare PIN
5H410CX29Medicare PIN
LA5H410Medicare PIN