# EYE CLINIC A PROFESSIONAL MEDICAL CORP.

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

## Provider details

- **NPI number:** 1619915121
- **Authorized official:** DR. LEWIS V MURRAY M.D. (PRESIDENT)
- **Authorized official phone:** (337) 478-3810

## Contact information

- **Practice address:** 1767 IMPERIAL BLVD, LAKE CHARLES, LA 70605-5362
- **Practice address phone:** (337) 478-3810
- **Practice address fax:** (337) 478-6360
- **Mailing address:** 1767 IMPERIAL BLVD, LAKE CHARLES, LA 70605-5362
- **Mailing address phone:** (337) 478-3810
- **Mailing address fax:** (337) 478-6360

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | — |
| 152W00000X | Optometrist | — | — | — |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/04/2006
- **Last updated:** 11/30/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1126675 | — | LA |