# FALGOUST EYE MEDICAL AND SURGICAL

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

## Provider details

- **NPI number:** 1649285040
- **Authorized official:** MICHELLE M FALGOUST (DIRECTOR OF OPERATIONS)
- **Authorized official phone:** (337) 477-0963

## Contact information

- **Practice address:** 1980 TYBEE LANE, LAKE CHARLES, LA 70605-2400
- **Practice address phone:** (337) 477-0963
- **Practice address fax:** (337) 477-1912
- **Mailing address:** PO BOX 4765, LAKE CHARLES, LA 70606-4765
- **Mailing address phone:** (337) 477-0963
- **Mailing address fax:** (337) 477-1912

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | MD12137R | LA | Yes |

## Other

- **Enumeration date:** 07/31/2006
- **Last updated:** 09/02/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1695807 | — | LA |
| 01 | — | 435194099B | BCBS | LA |