Provider Demographics
NPI:1376649939
Name:SURGICAL EYE ASSOCIATES
Entity Type:Organization
Organization Name:SURGICAL EYE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BESSENT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-893-5777
Mailing Address - Street 1:1120 N HIGHWAY 190
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-5178
Mailing Address - Country:US
Mailing Address - Phone:985-893-5777
Mailing Address - Fax:985-892-6285
Practice Address - Street 1:1120 N HIGHWAY 190
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-5178
Practice Address - Country:US
Practice Address - Phone:985-893-5777
Practice Address - Fax:985-892-6285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1799386Medicaid
LA1799386Medicaid
LA0435280002Medicare NSC