Healthcare Provider Details

I. General information

NPI: 1275528051
Provider Name (Legal Business Name): WALDEMAR TORRES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: WALDEMAR TORRES-CARLO MD

II. Dates (important events)

Enumeration Date: 09/16/2005
Last Update Date: 10/02/2020
Certification Date: 10/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3530 HOUMA BLVD STE 203
METAIRIE LA
70006-4203
US

IV. Provider business mailing address

3530 HOUMA BLVD STE 203
METAIRIE LA
70006-4203
US

V. Phone/Fax

Practice location:
  • Phone: 504-887-7660
  • Fax: 504-887-9098
Mailing address:
  • Phone: 504-887-7660
  • Fax: 504-887-9098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD.207519
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License NumberL2703
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License NumberMD.207519
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: