# EYE CENTER OF DENHAM SPRINGS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083865794
- **Authorized official:** DR. BRANDON BOYD WAX O.D. (OPTOMETRIST)
- **Authorized official phone:** (225) 665-2828

## Contact information

- **Practice address:** 206 PETES HWY, DENHAM SPRINGS, LA 70726-3842
- **Practice address phone:** (225) 665-2828
- **Practice address fax:** (225) 665-2820
- **Mailing address:** 206 PETES HWY, DENHAM SPRINGS, LA 70726-3842
- **Mailing address phone:** (225) 665-2828
- **Mailing address fax:** (225) 665-2820

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | 1537-559T | LA | Yes |

## Other

- **Enumeration date:** 10/01/2008
- **Last updated:** 01/13/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1083865794 | BLUE CROSS AND BLUE SHEILD OF LA | LA |
| 05 | — | 1509337 | — | LA |