Provider Demographics
NPI:1881379758
Name:LU, TERRY LAM (OD)
Entity type:Individual
Prefix:
First Name:TERRY
Middle Name:LAM
Last Name:LU
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:201 RUE IBERVILLE STE 800
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-8521
Mailing Address - Country:US
Mailing Address - Phone:337-235-2149
Mailing Address - Fax:
Practice Address - Street 1:4313 I 49 S SERVICE RD
Practice Address - Street 2:
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570-0755
Practice Address - Country:US
Practice Address - Phone:337-942-2024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-19
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1985-931AT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist