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General NPI Number Information
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NPI Number | 1487059648
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Entity Type | Organization
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Legal Business Name | A.N. LOUIS, O.D., P.C.
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Dates
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Enumeration Date | 10/30/2014
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Last Update Date | 10/30/2014
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Provider Practice Location Address
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Address Line | 10051 QUAIL RIDGE DR
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City | LA VISTA
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State | NE
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Zip | 68128-3196
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Country | US
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Telephone | 402-315-3797
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Fax |
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Provider Business Mailing Address
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Address Line | 10051 QUAIL RIDGE DR
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City | LA VISTA
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State | NE
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Zip | 68128-3196
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Country | US
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Telephone | 402-315-3797
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Fax |
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Authorized Official
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Title or Position | O.D./ PRESIDENT
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Name | DR. ANDRIA LOUIS
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Credential | O.D.
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Telephone | 402-679-1423
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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 | 1186
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License Number State | NE
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