Provider Demographics
NPI:1144690801
Name:COMPLETE FAMILY EYE CARE LLC
Entity type:Organization
Organization Name:COMPLETE FAMILY EYE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGER/OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:HANNAH
Authorized Official - Middle Name:
Authorized Official - Last Name:EASTMAN FAWCETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-660-2628
Mailing Address - Street 1:22141 ELTON DR
Mailing Address - Street 2:
Mailing Address - City:JENNINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70546-8542
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:339 W PRIEN LAKE RD
Practice Address - Street 2:SUITE 200 B
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-8452
Practice Address - Country:US
Practice Address - Phone:337-366-0905
Practice Address - Fax:337-474-1409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-06
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1649-683T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty