Individual
DANYETTA D THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1514 JEFFERSON HWY, JEFFERSON, LA 70121-2429
(866) 624-7637
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1814-748AT
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01452353
—
MS
05
—
2430688
—
LA
Enumeration date
08/02/2016
Last updated
01/19/2017
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