Williamson Eye Center | |
2308 S Burnside Ave, Gonzales, LA 70737-4643 | |
(225) 644-7525 | |
(225) 647-3710 |
Full Name | Williamson Eye Center |
---|---|
Type | Facility |
Speciality | Ophthalmology |
Location | 2308 S Burnside Ave, Gonzales, Louisiana |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1699812909 | NPI | - | NPPES |
1797359 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 773206T (Louisiana) | Secondary |
152W00000X | Optometrist | 830260T (Louisiana) | Secondary |
207W00000X | Ophthalmology | MD014115 (Louisiana) | Primary |
Provider Name | Edwin F Adams |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1437155793 PECOS PAC ID: 3577557586 Enrollment ID: I20040413000488 |
Provider Name | Charles Williamson |
---|---|
Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1396740122 PECOS PAC ID: 7719971878 Enrollment ID: I20050318000147 |
Provider Name | Richard L Granger |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1720058878 PECOS PAC ID: 2163453937 Enrollment ID: I20050823000004 |
Provider Name | William R Williamson |
---|---|
Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1114924560 PECOS PAC ID: 1850317355 Enrollment ID: I20051024000144 |
Provider Name | Christine D Norred |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1013949833 PECOS PAC ID: 4284633751 Enrollment ID: I20061211000202 |
Provider Name | Jeffery L Dibenedetto |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1255360525 PECOS PAC ID: 0547366098 Enrollment ID: I20070501000101 |
Provider Name | Cory J Boudreaux |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1790940096 PECOS PAC ID: 1254408669 Enrollment ID: I20080927000014 |
Provider Name | Elizabeth M Granger |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1730158841 PECOS PAC ID: 0749337251 Enrollment ID: I20090420000333 |
Provider Name | Joe M Gannon |
---|---|
Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1992700256 PECOS PAC ID: 3870669898 Enrollment ID: I20100910000078 |
Provider Name | Vincent O. Rachal |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1699770404 PECOS PAC ID: 8123203015 Enrollment ID: I20110419000286 |
Provider Name | Lawrence Pham |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1730444704 PECOS PAC ID: 0345498069 Enrollment ID: I20120920000658 |
Provider Name | Matthew D Smith |
---|---|
Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1780817551 PECOS PAC ID: 5799929147 Enrollment ID: I20130925000206 |
Provider Name | Blake A Booth |
---|---|
Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1194915249 PECOS PAC ID: 0446428403 Enrollment ID: I20150417001473 |
Provider Name | Blake Kennedy Williamson |
---|---|
Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1720370067 PECOS PAC ID: 5193031391 Enrollment ID: I20150902002968 |
Provider Name | Joshua R Davidson |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1881026003 PECOS PAC ID: 2668773524 Enrollment ID: I20151217001915 |
Provider Name | Bichngoc Pham |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1942725304 PECOS PAC ID: 9133493430 Enrollment ID: I20170926001664 |
Provider Name | Gabrielle Gandy Boyd |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1730687260 PECOS PAC ID: 8527316272 Enrollment ID: I20180813001429 |
Provider Name | Justin Lee Zachary |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1508478025 PECOS PAC ID: 2466870621 Enrollment ID: I20200921000970 |
Provider Name | Matthew Neil Barnes |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1295340370 PECOS PAC ID: 4587084868 Enrollment ID: I20201027000712 |
Provider Name | Andrew Mark Leto |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1093387144 PECOS PAC ID: 8729482591 Enrollment ID: I20210802003106 |
Provider Name | Clayton Patrick |
---|---|
Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1750812194 PECOS PAC ID: 0941564322 Enrollment ID: I20220817002038 |
Provider Name | Hannah Chustz |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1770210114 PECOS PAC ID: 1759765076 Enrollment ID: I20220904000100 |
Provider Name | Dustin Michael Weidert |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1083341515 PECOS PAC ID: 0446634729 Enrollment ID: I20220906001821 |
Provider Name | Shruti Patel |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1417402439 PECOS PAC ID: 7810246337 Enrollment ID: I20240612001619 |
Mailing Address | Practice Location Address |
---|---|
Williamson Eye Center 2308 S Burnside Ave, Gonzales, LA 70737-4643 Ph: (225) 644-7525 | Williamson Eye Center 2308 S Burnside Ave, Gonzales, LA 70737-4643 Ph: (225) 644-7525 |