Individual
DR. CHARLES A NASSAUER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
170 NORTHSHORE BLVD STE C, SLIDELL, LA 70460-6849
(985) 641-1228
(985) 643-1359
Mailing address
8614 WESTWOOD CENTER DR FL 9, VIENNA, VA 22182-2442
(703) 847-8899
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
919183T
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1380873
—
LA
01
—
721158167
TAX PAY ID
LA
01
—
LA9183
EYE MED ID
LA
01
—
LA99183
VBA ID
LA
01
—
MN4126858
HUMANA ID
LA
Enumeration date
02/16/2007
Last updated
07/12/2022
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