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General NPI Number Information
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NPI Number | 1932100799
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Entity Type | Individual
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Provider Name | ROBERT DICK ROSS MD
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Gender | Male
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Dates
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Enumeration Date | 08/02/2005
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Last Update Date | 09/27/2011
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Provider Practice Location Address
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Address Line | 4224 HOUMA BLVD SUITE 430
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City | METAIRIE
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State | LA
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Zip | 70006-2933
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Country | US
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Telephone | 504-888-7771
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Fax | 504-888-9388
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Provider Business Mailing Address
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Address Line | 1 HOLYLAND DR
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City | METAIRIE
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State | LA
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Zip | 70006-1055
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Country | US
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Telephone | 504-888-7771
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Fax | 504-888-9388
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 10706R
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 14895
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License Number State | MS
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