Organization
EYELID PLASTIC SURGERY & RECONSTRUCTIVE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KYLE V ACOSTA M.D. (OPHTHALMOLOGIST)
(985) 898-2001
Entity
Organization
Contact information
Practice address
200 GREENBRIAR BLVD, SUITE B, COVINGTON, LA 70433-7235
(985) 898-2001
(985) 898-2909
Mailing address
200 GREENBRIAR BLVD, SUITE B, COVINGTON, LA 70433-7235
(985) 898-2001
(985) 898-2909
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
23847
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1443000
—
LA
Enumeration date
04/26/2007
Last updated
04/30/2008
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