Most Relevant Information
Provider Data
| NPI Number: | 1003393240 |
| Provider Name: | KATHERINE J. FONTENOT O.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 152W00000X |
| Specialty: | Optometrist |
| License Number: | 1876-811AT |
Most Important Dates
| Enumeration Date: | 07/20/2018 |
| Last Updated: | 07/20/2018 |
Provider Practice Location
1767 IMPERIAL BLVD
LAKE CHARLES
LA
706055362
Practice Location Phone/Fax
| Phone: | 3374783810 |
| Fax: | 3374786360 |
Provider Mailing Location
1767 IMPERIAL BLVD
LAKE CHARLES
LA
706055362
Provider Mailing Phone/Fax
| Phone: | 3374783810 |
| Fax: | 3374786360 |