Provider Demographics
NPI:1649433475
Name:ABDA, RICHARD CHARLES (OCULARIST)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:CHARLES
Last Name:ABDA
Suffix:
Gender:M
Credentials:OCULARIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-02
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1508156FX1700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1700XEye and Vision Services ProvidersTechnician/TechnologistOcularist