Provider Demographics
NPI:1558875047
Name:MCCAULEY VISION, LLC
Entity Type:Organization
Organization Name:MCCAULEY VISION, LLC
Other - Org Name:20/20 VISION CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDSEY
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:MCCAULEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:318-709-4704
Mailing Address - Street 1:2345 REGENA DR
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70611-4538
Mailing Address - Country:US
Mailing Address - Phone:318-709-4704
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:337-478-2020
Practice Address - Fax:337-478-7732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-20
Last Update Date:2017-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1806740AT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty