Healthcare Provider Details

I. General information

NPI: 1417138751
Provider Name (Legal Business Name): DEVJANI LAHIRI-MUNIR, A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2007
Last Update Date: 06/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 IBERVILLE ST
DONALDSONVILLE LA
70346
US

IV. Provider business mailing address

309 IBERVILLE ST
DONALDSONVLLE LA
70346-2421
US

V. Phone/Fax

Practice location:
  • Phone: 225-473-3124
  • Fax: 225-473-7006
Mailing address:
  • Phone: 225-473-3124
  • Fax: 225-473-7006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number1325459T
License Number StateLA

VIII. Authorized Official

Name: DEVJANI LAHIRI-MUNIR
Title or Position: PRESIDENT
Credential: O.D
Phone: 225-473-3124