Provider Demographics
NPI:1174696991
Name:GLASER VISION VENTURES, INC.
Entity type:Organization
Organization Name:GLASER VISION VENTURES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:G
Authorized Official - Last Name:GLASER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:504-866-7352
Mailing Address - Street 1:8040 SAINT CHARLES AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70118-2747
Mailing Address - Country:US
Mailing Address - Phone:504-866-6311
Mailing Address - Fax:504-866-7789
Practice Address - Street 1:8040 SAINT CHARLES AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118-2747
Practice Address - Country:US
Practice Address - Phone:504-866-6311
Practice Address - Fax:504-866-7789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA56931Medicare PIN