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Organization
EYE CENTER OF DENHAM SPRINGS LLC
Active
Organization
EYE CENTER OF DENHAM SPRINGS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRANDON BOYD WAX O.D. (OPTOMETRIST)
(225) 665-2828
Entity
Organization
Contact information
Practice address
206 PETES HWY, DENHAM SPRINGS, LA 70726-3842
(225) 665-2828
(225) 665-2820
Mailing address
206 PETES HWY, DENHAM SPRINGS, LA 70726-3842
(225) 665-2828
(225) 665-2820
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1537-559T
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1083865794
BLUE CROSS AND BLUE SHEILD OF LA
LA
05
—
1509337
—
LA
Enumeration date
10/01/2008
Last updated
01/13/2011
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