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General NPI Number Information
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NPI Number | 1174597868
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Entity Type | Organization
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Legal Business Name | CHILDRENS EYE CARE OF NORTH TEXAS PA
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Dates
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Enumeration Date | 02/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4112 W 15TH ST STE 201
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City | PLANO
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State | TX
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Zip | 75093
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Country | US
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Telephone | 972-985-1233
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Fax | 972-985-9939
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Provider Business Mailing Address
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Address Line | 4112 W 15TH ST STE 201
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City | PLANO
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State | TX
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Zip | 75093
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Country | US
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Telephone | 972-985-1233
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Fax | 972-985-9939
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Authorized Official
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Title or Position | OWNER
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Name | JOEL NORMAN LEFFLER
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Credential | MD
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Telephone | 972-985-1233
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | G8617
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License Number State | TX
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