Provider Demographics
NPI:1619288198
Name:PATRICK R MAGEE OD APOC
Entity Type:Organization
Organization Name:PATRICK R MAGEE OD APOC
Other - Org Name:EYE HEALTH PLUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR OF OPTOMETRY
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:R
Authorized Official - Last Name:MAGEE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:337-984-2020
Mailing Address - Street 1:4510 AMBASSADOR CAFFERY PKWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-6931
Mailing Address - Country:US
Mailing Address - Phone:337-984-2020
Mailing Address - Fax:713-995-0548
Practice Address - Street 1:4510 AMBASSADOR CAFFERY PKWY
Practice Address - Street 2:SUITE A
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-6931
Practice Address - Country:US
Practice Address - Phone:337-984-2020
Practice Address - Fax:713-995-0548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-29
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA916-070T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA916-070TOtherOPTOMETRY LICENSE
LA47814Medicare PIN