Provider Demographics
NPI:1902088198
Name:YOUNG EYES, L.L.C.
Entity Type:Organization
Organization Name:YOUNG EYES, L.L.C.
Other - Org Name:YOUNG VISION GROUP
Other - Org Type:Other Name
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:BYRON
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-857-5567
Mailing Address - Street 1:PO BOX 1077
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70592-1077
Mailing Address - Country:US
Mailing Address - Phone:337-857-5567
Mailing Address - Fax:337-857-5550
Practice Address - Street 1:327 IBERIA ST
Practice Address - Street 2:
Practice Address - City:YOUNGSVILLE
Practice Address - State:LA
Practice Address - Zip Code:70592-5738
Practice Address - Country:US
Practice Address - Phone:337-893-8976
Practice Address - Fax:337-893-8972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-29
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.013947261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1320935Medicaid