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General NPI Number Information
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NPI Number | 1487826996
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Entity Type | Organization
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Legal Business Name | EYES & EYEWEAR INC.
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Dates
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Enumeration Date | 03/25/2008
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Last Update Date | 05/31/2012
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Provider Practice Location Address
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Address Line | 6823 PINES RD SUITE B
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City | SHREVEPORT
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State | LA
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Zip | 71129-5205
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Country | US
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Telephone | 318-688-3050
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Fax | 318-688-3233
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Provider Business Mailing Address
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Address Line | 6823 PINES RD SUITE B
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City | SHREVEPORT
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State | LA
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Zip | 71129-5205
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Country | US
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Telephone | 318-688-3050
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Fax | 318-688-3233
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Authorized Official
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Title or Position | OWNER
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Name | DONALD WALKER
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Credential | O.D.
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Telephone | 318-688-3050
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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 | 809097T
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License Number State | LA
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