Provider Demographics
NPI:1922140623
Name:FYEO, LLC
Entity Type:Organization
Organization Name:FYEO, LLC
Other - Org Name:FOR YOUR EYES ONLY 20/20
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:MS
Authorized Official - First Name:DAPHNE
Authorized Official - Middle Name:L
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:II
Authorized Official - Credentials:OD
Authorized Official - Phone:504-896-7661
Mailing Address - Street 1:4220 A MAGAZINE ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115
Mailing Address - Country:US
Mailing Address - Phone:504-896-7661
Mailing Address - Fax:504-896-7656
Practice Address - Street 1:4220 A MAGAZINE ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115
Practice Address - Country:US
Practice Address - Phone:504-896-7661
Practice Address - Fax:504-896-7656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1353487T152W00000X
LA1353-487T152W00000X
LA1374-509T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1145157Medicaid
LA2102265Medicaid
LA2102265Medicaid
LAU91795Medicare UPIN
LA1145157Medicaid