Provider Demographics
NPI:1710995402
Name:EYEDOX INC.
Entity Type:Organization
Organization Name:EYEDOX INC.
Other - Org Name:EYEDOX INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:MULLER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:504-281-2242
Mailing Address - Street 1:9128 W JUDGE PEREZ DRIVE
Mailing Address - Street 2:
Mailing Address - City:CHALMETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70043-1614
Mailing Address - Country:US
Mailing Address - Phone:504-281-2242
Mailing Address - Fax:
Practice Address - Street 1:9128 W JUDGE PEREZ DR
Practice Address - Street 2:
Practice Address - City:CHALMETTE
Practice Address - State:LA
Practice Address - Zip Code:70043-4527
Practice Address - Country:US
Practice Address - Phone:504-281-2242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2009-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA898-016T152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1314625Medicaid
LA1841230521OtherPERSONAL NPI
LA5CV53Medicare PIN
LA1841230521OtherPERSONAL NPI
LAT19570Medicare UPIN