Individual
THEODORE A. IRRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3434 HOUMA BLVD, SUITE 200, METAIRIE, LA 70006-4200
(504) 458-6061
(504) 866-0206
Mailing address
3434 HOUMA BLVD STE 200, METAIRIE, LA 70006-4278
(504) 458-6061
(504) 866-0206
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
11701R
LA
208000000X
Pediatrics Physician
MD.08928R
LA
208D00000X
General Practice Physician
MD.08928R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1977276
—
LA
Enumeration date
05/18/2006
Last updated
09/02/2009
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