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Organization
BOSSIER EYE INSTITUTE LLC
Active
Organization
BOSSIER EYE INSTITUTE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WALLY NAWAS MD (OWNER)
(318) 746-2020
Entity
Organization
Contact information
Practice address
2300 HOSPITAL DR, SUITE 140, BOSSIER CITY, LA 71111-2394
(318) 746-2020
Mailing address
2300 HOSPITAL DR, SUITE 140, BOSSIER CITY, LA 71111-2394
(318) 746-2020
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
024997
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1423351
—
LA
Enumeration date
04/03/2007
Last updated
03/30/2009
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