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Vision Source Alexandria LLC

NPI 1356694434ActiveOrganization· Optometrist· Alexandria, LA

Optometrist in Alexandria, Louisiana, registered in NPPES in October 2012. The authorized official on file is Lacy B. Shaw, O.D., Owner/Doctor. Enrolled in Medicare as part b supplier - clinic/group practice.

Overview

NPI1356694434
StatusActive
Entity typeOrganization
NPI issuedOct 26, 2012
Last updated in NPPESOct 26, 2012

Specialties and licenses

TaxonomyCodeLicenseState
Optometrist Primary152W00000X734-081TLA

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Oct 9, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 10, 2026No match—
New York OMIG · Nov 10, 2026No match—
Ohio Medicaid · Nov 10, 2026No match—
Pennsylvania Medicheck · Nov 10, 2026No match—
Washington HCA · Nov 10, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Enrolled Part B Supplier - Clinic/Group Practice (LA)

Medicare sources and data years

Other Optometrist providers in Alexandria

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