Provider Demographics
NPI:1669650149
Name:CLOUTIER EYECARE, APOC
Entity Type:Organization
Organization Name:CLOUTIER EYECARE, APOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:ARNOLD
Authorized Official - Last Name:CLOUTIER
Authorized Official - Suffix:JR
Authorized Official - Credentials:OD
Authorized Official - Phone:985-872-2020
Mailing Address - Street 1:130 ENTERPRISE DRIVE
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-2439
Mailing Address - Country:US
Mailing Address - Phone:985-872-2020
Mailing Address - Fax:985-872-2069
Practice Address - Street 1:130 ENTERPRISE DRIVE
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-2439
Practice Address - Country:US
Practice Address - Phone:985-872-2020
Practice Address - Fax:985-872-2069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-06
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA967-120T332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1950742Medicaid
LA0800950001OtherDME
LA47968OtherMEDICARE LEGACY
LA1950742Medicaid
LAT19486Medicare UPIN
LA0800950001Medicare NSC