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General NPI Number Information
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NPI Number | 1386715985
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Entity Type | Organization
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Legal Business Name | THE HAMMOND EYE CLINIC, L.L.C.
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 09/21/2012
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Provider Practice Location Address
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Address Line | 110 W ROBERT ST
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City | HAMMOND
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State | LA
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Zip | 70401-3227
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Country | US
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Telephone | 985-345-0607
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Fax | 985-345-0490
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Provider Business Mailing Address
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Address Line | 110 W ROBERT ST
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City | HAMMOND
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State | LA
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Zip | 70401-3227
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Country | US
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Telephone | 985-345-0607
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Fax | 985-345-0490
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALAN RICHARD PRADILLO
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Credential | O.D.
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Telephone | 985-345-0607
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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 | 1534-565T
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License Number State | LA
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