Provider Demographics
NPI:1730444704
Name:PHAM, LAWRENCE HOANG (OD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:HOANG
Last Name:PHAM
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:550 CONNELL PARK LN
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-6539
Mailing Address - Country:US
Mailing Address - Phone:225-274-3937
Mailing Address - Fax:225-924-2809
Practice Address - Street 1:2308 S BURNSIDE AVE
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-4643
Practice Address - Country:US
Practice Address - Phone:225-664-7525
Practice Address - Fax:225-647-3710
Is Sole Proprietor?:No
Enumeration Date:2012-07-05
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA1643-677AT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist