Organization
STEPHEN E. WARREN LLC
Active
Other names
St. Charles Vision Outlet
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN E. WARREN O.D. (OWNER)
(985) 542-9410
Entity
Organization
Contact information
Practice address
800 C M FAGAN DR, SUITE F, HAMMOND, LA 70403-6062
(985) 542-9410
(985) 542-5046
Mailing address
800 C M FAGAN DR, SUITE F, HAMMOND, LA 70403-6062
(985) 542-9410
(985) 542-5046
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
756192T
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
$$$$$$$$$
SOCIAL SECURITY NUMBER
LA
05
—
1447391
—
LA
Enumeration date
03/22/2007
Last updated
08/22/2020
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