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General NPI Number Information
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NPI Number | 1366563405
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Entity Type | Organization
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Legal Business Name | LOUISIANA EYE CENTER, APMC
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 01/29/2008
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Provider Practice Location Address
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Address Line | 7855 HOWELL BLVD SUITE 130A
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City | BATON ROUGE
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State | LA
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Zip | 70807
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Country | US
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Telephone | 225-356-2655
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Fax | 225-356-2358
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Provider Business Mailing Address
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Address Line | 7855 HOWELL BLVD SUITE 130A
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City | BATON ROUGE
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State | LA
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Zip | 70807
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Country | US
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Telephone | 225-356-2655
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Fax | 225-356-2358
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Authorized Official
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Title or Position | PHYSCIAN
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Name | DR. ANGELA RICELLE LEWIS
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Credential | MD
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Telephone | 225-356-2655
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 020628
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License Number State | LA
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