Healthcare Provider Details

I. General information

NPI: 1316090194
Provider Name (Legal Business Name): EYEGLASSES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 05/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2774 RODEO RD
ABBEVILLE LA
70510-4053
US

IV. Provider business mailing address

PO BOX 2133
ABBEVILLE LA
70511-2133
US

V. Phone/Fax

Practice location:
  • Phone: 337-893-8976
  • Fax:
Mailing address:
  • Phone: 337-893-8976
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. BYRON ANDREW YOUNG
Title or Position: PRESIDENT
Credential:
Phone: 337-893-8976