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General NPI Number Information
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NPI Number | 1285522417
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Entity Type | Organization
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Legal Business Name | LAFAYETTE PREMIER VISION CENTER LLC
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Dates
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Enumeration Date | 06/26/2025
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Last Update Date | 06/26/2025
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Provider Practice Location Address
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Address Line | 814 VETERANS DR
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City | CARENCRO
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State | LA
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Zip | 70520-3701
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Country | US
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Telephone | 337-781-5771
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Fax |
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Provider Business Mailing Address
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Address Line | 1012 CLINE DR
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City | BREAUX BRIDGE
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State | LA
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Zip | 70517-7625
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICAL
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Name | SHAMEKIA NWAFOR
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Credential |
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Telephone | 337-781-5771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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