Healthcare Provider Details

I. General information

NPI: 1366400889
Provider Name (Legal Business Name): LOUISIANA RETINA CONSULTANTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W PINHOOK RD STE 301
LAFAYETTE LA
70503-2460
US

IV. Provider business mailing address

1000 W PINHOOK RD STE 301
LAFAYETTE LA
70503-2460
US

V. Phone/Fax

Practice location:
  • Phone: 337-264-1011
  • Fax: 337-264-1211
Mailing address:
  • Phone: 337-264-1011
  • Fax: 337-264-1211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT I BLEM
Title or Position: PHYSICIAN
Credential:
Phone: 337-264-1011