Provider Demographics
NPI:1215553664
Name:CASADABAN, KATHERINE MAE (OD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:MAE
Last Name:CASADABAN
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 1:3221 N CAUSEWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002
Mailing Address - Country:US
Mailing Address - Phone:504-737-3456
Mailing Address - Fax:504-738-3456
Practice Address - Street 1:3221 N CAUSEWAY BLVD
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002
Practice Address - Country:US
Practice Address - Phone:504-737-3456
Practice Address - Fax:504-738-3456
Is Sole Proprietor?:No
Enumeration Date:2020-06-22
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1924-860AT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist