Provider Demographics
NPI:1710312103
Name:MOREAU EYE CARE, LLC
Entity Type:Organization
Organization Name:MOREAU EYE CARE, LLC
Other - Org Name:PERFORMANCE VISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:MOREAU
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:812-474-0006
Mailing Address - Street 1:P.O. BOX 5313
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47716-5313
Mailing Address - Country:US
Mailing Address - Phone:812-474-0006
Mailing Address - Fax:812-474-1851
Practice Address - Street 1:4221 WASHINGTON AVENUE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-0889
Practice Address - Country:US
Practice Address - Phone:812-474-0006
Practice Address - Fax:812-474-1851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-04
Last Update Date:2023-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003804A152W00000X
IN18003805A152W00000X
152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty