Provider Demographics
NPI:1407321961
Name:MCCAIN FAMILY EYECARE, LLC
Entity Type:Organization
Organization Name:MCCAIN FAMILY EYECARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:M
Authorized Official - Last Name:MCCAIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:337-372-1333
Mailing Address - Street 1:4816 NELSON RD
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70605-5214
Mailing Address - Country:US
Mailing Address - Phone:337-372-1333
Mailing Address - Fax:
Practice Address - Street 1:4816 NELSON RD
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-5214
Practice Address - Country:US
Practice Address - Phone:337-372-1333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-10
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1885-820ATOtherSTATE LICENSE NUMBER