Provider Demographics
NPI:1851149025
Name:BIETTE, SYDNEY (OD)
Entity type:Individual
Prefix:DR
First Name:SYDNEY
Middle Name:
Last Name:BIETTE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1776 CONTINENTAL DR UNIT 113
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-7279
Mailing Address - Country:US
Mailing Address - Phone:317-512-6101
Mailing Address - Fax:
Practice Address - Street 1:1431 OCHSNER BLVD STE A
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-8246
Practice Address - Country:US
Practice Address - Phone:985-875-7898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-10
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2038-984AT152W00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program