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Organization
JENNIFER TATE BRASSEAUX, OD, LLC
Active
Organization
JENNIFER TATE BRASSEAUX, OD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER CLAIRE TATE-BRASSEAUX O.D (OWNER)
(337) 407-2888
Entity
Organization
Contact information
Practice address
138 LAZARO BLVD, SUITE A, OPELOUSAS, LA 70570-9115
(337) 407-2888
(337) 407-2999
Mailing address
138 LAZARO BLVD, SUITE B, OPELOUSAS, LA 70570-9115
(337) 407-2888
(337) 407-2999
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1542-573T
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1021369
—
LA
Enumeration date
08/12/2009
Last updated
10/12/2022
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