MEDICARE: DR. PAUL ETIENNE PROUET JR. O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	1274-431T	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184686420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL ETIENNE PROUET JR. O.D.

Provider Business Mailing Address
First Line	:	5554 JACQUELYN CT
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70124-1047
Country	:	US
Telephone Number	:	504-782-2990
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 WILLIAMS BLVD
Second Line	:
City	:	KENNER
State	:	LA
Zip	:	70062-7632
Country	:	US
Telephone Number	:	504-461-5500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2006
Last Update Date	:	11/17/2023

Similar Medicare Providers

1821326737 — RIVERTOWN OPTICAL SHOP
Practice Location Address:

400 WILLIAMS BLVD
KENNER, LA
70062-7632

Practice Phone: 504-461-5500
Practice Fax:

1497111876 — CHANTEL MARIE VICKS MA
Practice Location Address:

2400 VETERANS MEMORIAL BLVD , SUITE 215
KENNER, LA
70062-4715

Practice Phone: 504-405-5280
Practice Fax: 504-405-5434

1679555882 — ADVANCED MEDICAL EQUIPMENT, INC.
Practice Location Address:

33 VETERANS MEMORIAL BLVD
KENNER, LA
70062-4937

Practice Phone: 504-463-0550
Practice Fax: 504-463-0096

1366421562 — MARIO KAKAZU M.D.
Practice Location Address:

2552 WILLIAMS BLVD
KENNER, LA
70062-5538

Practice Phone: 504-463-3002
Practice Fax:

1154399814 — INNOVATIVE ORTHOTICS AND PROSTHETICS OF LA, INC.
Practice Location Address:

720 WILLIAMS BLVD
KENNER, LA
70062-7638

Practice Phone: 504-464-5577
Practice Fax: 504-464-5677

1881656403 — DR. WYNN CHRISTOPHER RUSSO D.D.S.
Practice Location Address:

2301 WILLIAMS BLVD
KENNER, LA
70062-5721

Practice Phone: 504-887-7811
Practice Fax: 504-469-5181

Directions to “ DR. PAUL ETIENNE PROUET JR. O.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.