Organization
EYE CENTER OF DENHAM SPRINGS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRANDON BOYD WAX O.D. (OPTOMETRIST)
(225) 665-2828
Entity
Organization
Contact information
Practice address
206 PETES HWY, DENHAM SPRINGS, LA 70726-3842
(225) 665-2828
(225) 665-2820
Mailing address
206 PETES HWY, DENHAM SPRINGS, LA 70726-3842
(225) 665-2828
(225) 665-2820
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1537-559T
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1083865794
BLUE CROSS AND BLUE SHEILD OF LA
LA
05
—
1509337
—
LA
Enumeration date
10/01/2008
Last updated
01/13/2011
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