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Individual

GWEN MARIE COUSINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1 GALLERIA BLVD STE 900, METAIRIE, LA 70001-7528
(504) 895-3961
(504) 888-6045
Mailing address
1 GALLERIA BLVD STE 900, METAIRIE, LA 70001-7528
(504) 456-9061
(504) 888-6045

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
024983
LA
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
024983
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1421251
LA
Enumeration date
05/23/2006
Last updated
10/08/2025
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