Provider Demographics
NPI:1215142989
Name:C V EYECARE,LLC
Entity type:Organization
Organization Name:C V EYECARE,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARY
Authorized Official - Middle Name:J
Authorized Official - Last Name:VINCENT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:504-361-3937
Mailing Address - Street 1:608 TERRY PKWY
Mailing Address - Street 2:
Mailing Address - City:TERRYTOWN
Mailing Address - State:LA
Mailing Address - Zip Code:70056-4306
Mailing Address - Country:US
Mailing Address - Phone:504-361-3937
Mailing Address - Fax:504-364-5700
Practice Address - Street 1:608 TERRY PKWY
Practice Address - Street 2:
Practice Address - City:TERRYTOWN
Practice Address - State:LA
Practice Address - Zip Code:70056-4306
Practice Address - Country:US
Practice Address - Phone:504-361-3937
Practice Address - Fax:504-364-5700
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:C V EYECARE,LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-14
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA835-020T152W00000X
LA11192R152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1440183Medicaid
LA5C533Medicare ID - Type Unspecified
LA1440183Medicaid