# JOSEPH V SICA SR A PROFESSIONAL OPTOMETRIC CORP

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

## Provider details

- **NPI number:** 1942527940
- **Authorized official:** DR. JOSEPH VINCENT SICA O.D. (OPTOMETRIST)
- **Authorized official phone:** (985) 892-2722

## Contact information

- **Practice address:** 312 S JEFFERSON AVE, COVINGTON, LA 70433-3169
- **Practice address phone:** (985) 892-2722
- **Practice address fax:** (985) 892-3418
- **Mailing address:** 312 S JEFFERSON AVE, COVINGTON, LA 70433-3169
- **Mailing address phone:** (985) 892-2722
- **Mailing address fax:** (985) 892-3418

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | 631-088T | LA | Yes |

## Other

- **Enumeration date:** 04/29/2010
- **Last updated:** 01/12/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1040631 | — | LA |