Provider Demographics
NPI:1841491289
Name:HENRY A PRETUS MD PHD APMC
Entity type:Organization
Organization Name:HENRY A PRETUS MD PHD APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:PRETUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD PHD
Authorized Official - Phone:504-207-2222
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:70006-2932
Mailing Address - Country:US
Mailing Address - Phone:504-207-2222
Mailing Address - Fax:504-846-3002
Practice Address - Street 1:1057 PAUL MAILLARD RD
Practice Address - Street 2:SUITE 210
Practice Address - City:LULING
Practice Address - State:LA
Practice Address - Zip Code:70070-4349
Practice Address - Country:US
Practice Address - Phone:985-785-5610
Practice Address - Fax:504-846-3002
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HENRY A PRETUS MD PHD APMC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-31
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.10849R2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5CX29Medicare ID - Type UnspecifiedLULING GROUP
LAH18627Medicare UPIN