Healthcare Provider Details

I. General information

NPI: 1831354919
Provider Name (Legal Business Name): ALICIA PRICE CROOKS OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALICIA K PRICE OD

II. Dates (important events)

Enumeration Date: 07/28/2008
Last Update Date: 07/19/2024
Certification Date: 07/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2536 AIRLINE DRIVE
BOSSIER CITY LA
71111
US

IV. Provider business mailing address

461 LINTON RD
BENTON LA
71006
US

V. Phone/Fax

Practice location:
  • Phone: 318-742-9690
  • Fax: 318-747-9492
Mailing address:
  • Phone: 318-623-1664
  • Fax: 318-550-3432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1558590T
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: