MEDICARE: MEGHAN L. MCNEASE O.D., LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	1667-701T	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801229125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGHAN L. MCNEASE O.D., LLC

Provider Business Mailing Address
First Line	:	4255 BULL CHUTE RD
Second Line	:
City	:	OAK RIDGE
State	:	LA
Zip	:	71264-9152
Country	:	US
Telephone Number	:	318-614-4880
Fax Number	:	318-281-1635

Provider Business Practice Location Address
First Line	:	6091 MER ROUGE RD.
Second Line	:
City	:	BASTROP
State	:	LA
Zip	:	71220
Country	:	US
Telephone Number	:	318-281-1664
Fax Number	:	318-281-1635

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2013
Last Update Date	:	11/10/2023

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