Provider Demographics
NPI:1124268008
Name:TALAVERA, JULIE MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:MARIE
Last Name:TALAVERA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 HOUMA BLVD
Mailing Address - Street 2:STE 103
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2930
Mailing Address - Country:US
Mailing Address - Phone:504-455-1300
Mailing Address - Fax:504-455-1300
Practice Address - Street 1:3901 HOUMA BLVD
Practice Address - Street 2:STE 103
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2930
Practice Address - Country:US
Practice Address - Phone:504-455-1300
Practice Address - Fax:504-455-1300
Is Sole Proprietor?:No
Enumeration Date:2009-03-04
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.206674207RE0101X
TXN1913207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8BZ491OtherBCBS INDIVIDUAL #
TX8BZ491OtherBCBS INDIVIDUAL #
TX8L17586Medicare PIN