Healthcare Provider Details
I. General information
NPI: 1124071717
Provider Name (Legal Business Name): EYE ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/18/2006
Last Update Date: 06/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3530 HOUMA BLVD SUITE 203
METAIRIE LA
70006
US
IV. Provider business mailing address
3530 HOUMA BLVD STE 203
METAIRIE LA
70006-4202
US
V. Phone/Fax
- Phone: 504-887-7660
- Fax: 504-887-7816
- Phone: 504-887-7660
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
WILLIAM
DAVID
WILLIS
Title or Position: ADMINISTRATOR
Credential:
Phone: 504-455-1816