Provider Demographics
NPI:1487826996
Name:EYES & EYEWEAR INC.
Entity Type:Organization
Organization Name:EYES & EYEWEAR INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:318-688-3050
Mailing Address - Street 1:6823 PINES RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71129-5205
Mailing Address - Country:US
Mailing Address - Phone:318-688-3050
Mailing Address - Fax:318-688-3233
Practice Address - Street 1:6823 PINES RD
Practice Address - Street 2:SUITE B
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71129-5205
Practice Address - Country:US
Practice Address - Phone:318-688-3050
Practice Address - Fax:318-688-3233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-25
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA809097T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1342696Medicaid
LA439724581COtherBLUE CROSS OF LOUISIANA
LA4358428080OtherBLUE CROSS OF LOUISIANA
LA0359340001Medicare NSC
LAT19581Medicare UPIN
LA439724581COtherBLUE CROSS OF LOUISIANA
LAP00634832Medicare PIN
LA1342696Medicaid
LAP00946530Medicare PIN
LA48553DF43Medicare PIN