Active NPI
Zita Luna-Baniqued, M.D.
- Contractor
- Fort Polk, LA
National Provider Identifier
1669536686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- A37780
- Practice address
- 1585 Third St.
Bayne Jones Ach
Fort Polk, LA 71459-5110 - Phone
- (337) 531-3074
- Fax
- (337) 531-3709
- NPI assigned
- Dec 21, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | A37780 | CA | Primary |
Addresses
Primary practice location
1585 Third St.
Bayne Jones Ach
Fort Polk, LA 71459-5110
Mailing address
1605 Amour Dr
Leesville, LA 71446-5212
Phone (337) 238-9317
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A37780 | CA | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1669536686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1605 AMOUR DR",
"city": "LEESVILLE",
"state": "LA",
"postal_code": "714465212",
"telephone_number": "337-238-9317",
"fax_number": "337-531-3709"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1585 THIRD ST.",
"address_2": "BAYNE JONES ACH",
"city": "FORT POLK",
"state": "LA",
"postal_code": "714595110",
"telephone_number": "337-531-3074",
"fax_number": "337-531-3709"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUNA-BANIQUED",
"first_name": "ZITA",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "CA",
"license": "A37780",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Polk, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.