Individual
LUA WALTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2108 TEXAS AVE, STE 3080, ALEXANDRIA, LA 71301-3944
(318) 442-5758
(318) 445-7210
Mailing address
919 HIDDEN RDG, IRVING, TX 75038-3813
(469) 282-2711
(469) 282-2609
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD.207420
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2155610
—
LA
Enumeration date
07/08/2011
Last updated
01/18/2017
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