MEDICARE: DR. MICHAEL LEUNG O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	046.010293	IL
2	152W00000X	Optometrist	TA2193	MD
3	152W00000X	Optometrist	8781TG	TX

General Provider Information

NPI Number	:	1295966224
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL LEUNG O.D.

Provider Business Mailing Address
First Line	:	22001 SOUTHWEST FWY STE 215
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77469-7002
Country	:	US
Telephone Number	:	312-380-6453
Fax Number	:

Provider Business Practice Location Address
First Line	:	22001 SOUTHWEST FWY STE 215
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77469-7002
Country	:	US
Telephone Number	:	832-595-7700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2009
Last Update Date	:	05/16/2023

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