Provider Demographics
NPI:1346392313
Name:PUPILS OPTICAL LLC
Entity Type:Organization
Organization Name:PUPILS OPTICAL LLC
Other - Org Name:PUPIL'S CHOICE OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:G
Authorized Official - Last Name:HAIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-833-5573
Mailing Address - Street 1:2800 VETERANS BLVD
Mailing Address - Street 2:STE 125
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-6176
Mailing Address - Country:US
Mailing Address - Phone:504-833-9041
Mailing Address - Fax:504-832-9629
Practice Address - Street 1:2800 VETERANS BLVD
Practice Address - Street 2:STE 125
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-6176
Practice Address - Country:US
Practice Address - Phone:504-833-9041
Practice Address - Fax:504-832-9629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5354170001Medicare ID - Type Unspecified