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Organization
STEPHEN E. WARREN LLC
Active
Organization
STEPHEN E. WARREN LLC
Active
Other names
St. Charles Vision Outlet
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN E. WARREN O.D. (OWNER)
(985) 542-9410
Entity
Organization
Contact information
Practice address
800 C M FAGAN DR, SUITE F, HAMMOND, LA 70403-6062
(985) 542-9410
(985) 542-5046
Mailing address
800 C M FAGAN DR, SUITE F, HAMMOND, LA 70403-6062
(985) 542-9410
(985) 542-5046
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
756192T
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
$$$$$$$$$
SOCIAL SECURITY NUMBER
LA
05
—
1447391
—
LA
Enumeration date
03/22/2007
Last updated
08/22/2020
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