Provider Demographics
NPI:1245319235
Name:ABDAS ARTIFICIAL EYE AND FACIAL CENTER INC
Entity type:Organization
Organization Name:ABDAS ARTIFICIAL EYE AND FACIAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:ABDA
Authorized Official - Suffix:
Authorized Official - Credentials:OCULARIST
Authorized Official - Phone:504-469-3937
Mailing Address - Street 1:PO BOX 415
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70063-0415
Mailing Address - Country:US
Mailing Address - Phone:504-469-3937
Mailing Address - Fax:504-469-3377
Practice Address - Street 1:3715 WILLIAMS BLVD STE 207
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065-3075
Practice Address - Country:US
Practice Address - Phone:504-469-3937
Practice Address - Fax:504-469-3377
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ABDAS ARTIFICIAL EYE AND FACIAL CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-02
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1508332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1324191Medicaid
LAB2973OtherBLUE CROSS BLUE SHIELD LA
LA=========OtherFAMILY HEALTH CARE
LA1324191Medicaid
LA=========OtherTENET
LA=========OtherSTERLING LIFE
LA=========OtherFARA
LA=========OtherBEST CARE
LA=========OtherAMERICAN LIFE CARE
LA=========OtherLA STATE EMPLOYEES GROUP
LA=========OtherUNITED HEALTHCARE
LAB2973OtherBLUE CROSS BLUE SHIELD LA
LA=========OtherAETNA
LA=========OtherCIGNA
LA=========OtherCHAMPUS/TRICARE
LA=========OtherGALAXY HEALTH
LA=========OtherCHAMPUS/TRICARE