Basic Information
Provider Information | |||||||||
NPI: | 1356346845 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | PREIS | ||||||||
FirstName: | LEHMAN | ||||||||
MiddleName: | K. | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | MD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 4200 HOUMA BLVD | ||||||||
Address2: | FL 2 | ||||||||
City: | METAIRIE | ||||||||
State: | LA | ||||||||
PostalCode: | 700062970 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5044544102 | ||||||||
FaxNumber: | 5044544192 | ||||||||
Practice Location | |||||||||
Address1: | 4200 HOUMA BLVD | ||||||||
Address2: | FL 2 | ||||||||
City: | METAIRIE | ||||||||
State: | LA | ||||||||
PostalCode: | 700062970 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5044544120 | ||||||||
FaxNumber: | 5044544192 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 06/20/2005 | ||||||||
LastUpdateDate: | 01/13/2017 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | X | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 013161 | LA | Y |   | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
ID | Type | State | Issuer | Description | 1316318 | 05 | LA |   | MEDICAID |