Provider Demographics
NPI:1104951904
Name:DRS LEBOEUF AND BURAS, AMC
Entity type:Organization
Organization Name:DRS LEBOEUF AND BURAS, AMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:FLOYD
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:BURAS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:504-309-9364
Mailing Address - Street 1:2800 VETERANS MEMORIAL BLVD
Mailing Address - Street 2:SUITE 340
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-6130
Mailing Address - Country:US
Mailing Address - Phone:504-309-9364
Mailing Address - Fax:504-309-9375
Practice Address - Street 1:2800 VETERANS MEMORIAL BLVD
Practice Address - Street 2:SUITE 340
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-6130
Practice Address - Country:US
Practice Address - Phone:504-309-9364
Practice Address - Fax:504-309-9375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1940305Medicaid