Individual
MRS. CHRISTIE CHILDRESS GOUDEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
108 MEDIC AVE, MARKSVILLE, LA 71351
(318) 253-9766
(318) 253-8094
Mailing address
108 MEDIC AVE, MARKSVILLE, LA 71351-3099
(318) 253-9766
(318) 253-8094
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1372-504T
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1479918
—
LA
05
—
1948691
—
LA
Enumeration date
05/23/2006
Last updated
01/24/2008
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