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General NPI Number Information
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NPI Number | 1528271822
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Entity Type | Organization
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Legal Business Name | CASANOVA EYE CARE, APMC
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 01/26/2010
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Provider Practice Location Address
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Address Line | 1110 DOCTOR AC TERRENCE BLVD SUITE 1
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City | OPELOUSAS
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State | LA
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Zip | 70570-6403
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Country | US
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Telephone | 337-942-3449
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Fax | 337-942-6019
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Provider Business Mailing Address
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Address Line | 1110 DOCTOR AC TERRENCE BLVD SUITE 1
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City | OPELOUSAS
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State | LA
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Zip | 70570-6403
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Country | US
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Telephone | 337-942-3449
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Fax | 337-942-6019
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT T. CASANOVA JR.
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Credential | M.D.
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Telephone | 337-942-3449
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 020117
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License Number State | LA
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