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VISION SOURCE ALEXANDRIA LLC NPI 1356694434


NPI Information

NPI: 1356694434
Provider Name: VISION SOURCE ALEXANDRIA LLC
Classification: Optometrist - 152W00000X
Entity Type: Organization

CLIA Number: 19D2093132

Address:
5615B JACKSON STREET EXT
ALEXANDRIA, LA
ZIP 71303
Phone: (318) 442-7787
Get Directions

VISION SOURCE ALEXANDRIA LLC is an optometrist in Alexandria, LA. The provider is doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. VISION SOURCE ALEXANDRIA LLC NPI is 1356694434. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5615B JACKSON STREET EXT
ALEXANDRIA, LA
ZIP 71303-275
Phone: (318) 442-7787
Fax: (318) 443-1654

The provider's authorized official is Lacy B Shaw .
The authorized official title is Owner/doctor and has the following contact phone number (318) 442-7787.

The CLIA number assigned to this NPI record is 19D2093132 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/26/2012 and was last updated on 10/26/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1152W00000XOptometrist734-081TLOUISIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11153486MEDICAIDLOUISIANA
248912MEDICARE UPINLOUISIANA
30439680001MEDICARE NSCLOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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