| |
2997 Highway 190, Mandeville, LA 70471-3298 | |
(985) 727-9948 | |
(985) 237-6008 |
Full Name | |
---|---|
Type | Facility |
Speciality | Technician/technologist - Optician |
Location | 2997 Highway 190, Mandeville, Louisiana |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1134152408 | NPI | - | NPPES |
1943436 | Medicaid | LA | |
1398969 | Medicaid | LA |
Provider Name | Glenn M Coullard |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1346209236 PECOS PAC ID: 3577577444 Enrollment ID: I20070219000588 |
Provider Name | Stephen Borchers |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1043403439 PECOS PAC ID: 0941393995 Enrollment ID: I20070906000618 |
Provider Name | Janie Tran |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1609122217 PECOS PAC ID: 1355575648 Enrollment ID: I20130927000112 |
Provider Name | Brian J Bratcher |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1407238777 PECOS PAC ID: 5597071449 Enrollment ID: I20150909000092 |
Provider Name | Greyssy L Melgar |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1346792918 PECOS PAC ID: 6002196631 Enrollment ID: I20161216001242 |
Provider Name | Shaista Vally |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1619343712 PECOS PAC ID: 3173830734 Enrollment ID: I20190909000188 |
Mailing Address | Practice Location Address |
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Po Box 1950, Mandeville, LA 70470-1950 Ph: (985) 727-9948 | 2997 Highway 190, Mandeville, LA 70471-3298 Ph: (985) 727-9948 |