Provider Demographics
NPI:1831114073
Name:OSTRICK, DAVID MICHAEL (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MICHAEL
Last Name:OSTRICK
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:529 BROCKENBRAUGH CT
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-2709
Mailing Address - Country:US
Mailing Address - Phone:504-831-2253
Mailing Address - Fax:
Practice Address - Street 1:1518 W AIRLINE HWY
Practice Address - Street 2:
Practice Address - City:LA PLACE
Practice Address - State:LA
Practice Address - Zip Code:70068-3725
Practice Address - Country:US
Practice Address - Phone:985-652-4097
Practice Address - Fax:985-652-4097
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA850-103T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1920223Medicaid
LAT69510Medicare UPIN
LA1920223Medicaid