Individual
DR. JENNIFER CLAIRE TATE-BRASSEAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
138 LAZARO BLVD, SUITE B, OPELOUSAS, LA 70570-9115
(337) 407-2888
(337) 407-2999
Mailing address
138 LAZARO BLVD, STE B, OPELOUSAS, LA 70570-9115
(337) 407-2888
(337) 407-2999
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1542-573AT
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1021369
—
LA
01
—
3A377
MEDICARE PTAN
LA
Enumeration date
07/31/2007
Last updated
10/12/2022
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