Provider Demographics
NPI:1417138751
Name:DEVJANI LAHIRI-MUNIR, A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:DEVJANI LAHIRI-MUNIR, A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEVJANI
Authorized Official - Middle Name:
Authorized Official - Last Name:LAHIRI-MUNIR
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:225-473-3124
Mailing Address - Street 1:309 IBERVILLE ST
Mailing Address - Street 2:
Mailing Address - City:DONALDSONVLLE
Mailing Address - State:LA
Mailing Address - Zip Code:70346-2421
Mailing Address - Country:US
Mailing Address - Phone:225-473-3124
Mailing Address - Fax:225-473-7006
Practice Address - Street 1:309 IBERVILLE ST
Practice Address - Street 2:
Practice Address - City:DONALDSONVILLE
Practice Address - State:LA
Practice Address - Zip Code:70346
Practice Address - Country:US
Practice Address - Phone:225-473-3124
Practice Address - Fax:225-473-7006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-15
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1325459T152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1114758Medicaid
LA1114758Medicaid