Provider Demographics
NPI:1770832149
Name:SCOTT EYE CARE LLC
Entity Type:Organization
Organization Name:SCOTT EYE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OD
Authorized Official - Prefix:
Authorized Official - First Name:RAYAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:CAZARES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:337-298-6293
Mailing Address - Street 1:5511 CAMERON ST
Mailing Address - Street 2:
Mailing Address - City:SCOTT
Mailing Address - State:LA
Mailing Address - Zip Code:70583-5201
Mailing Address - Country:US
Mailing Address - Phone:337-298-6293
Mailing Address - Fax:832-934-1161
Practice Address - Street 1:5511 CAMERON ST
Practice Address - Street 2:
Practice Address - City:SCOTT
Practice Address - State:LA
Practice Address - Zip Code:70583-5201
Practice Address - Country:US
Practice Address - Phone:337-298-6293
Practice Address - Fax:832-934-1161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-31
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1609-642T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty