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General NPI Number Information
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NPI Number | 1609028968
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Entity Type | Organization
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Legal Business Name | HART EYE CENTER, LLC
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Dates
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Enumeration Date | 10/17/2008
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Last Update Date | 08/19/2022
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Provider Practice Location Address
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Address Line | 1727 IMPERIAL BLVD BLDG. 1, STE. B
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City | LAKE CHARLES
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State | LA
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Zip | 70605-5362
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Country | US
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Telephone | 337-439-4014
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Fax | 337-439-0185
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Provider Business Mailing Address
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Address Line | 1920 WEST SALE ROAD BLDG. F, STE. 3
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City | LAKE CHARLES
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State | LA
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Zip | 70605-5362
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Country | US
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Telephone | 337-439-4014
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Fax | 337-439-0185
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Authorized Official
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Title or Position | OWNER/OPHTHALMOLOGIST
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Name | DR. WILLIAM BEROEN HART
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Credential | M.D.
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Telephone | 337-439-4014
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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 |
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License Number State |
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