Provider Demographics
NPI:1124071717
Name:EYE ASSOCIATES LLC
Entity type:Organization
Organization Name:EYE ASSOCIATES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:WILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-455-1816
Mailing Address - Street 1:3530 HOUMA BLVD
Mailing Address - Street 2:STE 203
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-4202
Mailing Address - Country:US
Mailing Address - Phone:504-887-7660
Mailing Address - Fax:
Practice Address - Street 1:3530 HOUMA BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006
Practice Address - Country:US
Practice Address - Phone:504-887-7660
Practice Address - Fax:504-887-7816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1441121Medicaid
1104014216OtherNPI
MS03258518Medicaid
MS03258518Medicaid
LACH3023Medicare PIN