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General NPI Number Information
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NPI Number | 1174988505
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Entity Type | Organization
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Legal Business Name | HOLUB EYECARE PLLC
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Dates
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Enumeration Date | 12/30/2015
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Last Update Date | 03/31/2017
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Provider Practice Location Address
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Address Line | 515 E COURT ST STE 200
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City | SEGUIN
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State | TX
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Zip | 78155-5750
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Country | US
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Telephone | 830-372-0550
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Fax | 830-372-4372
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Provider Business Mailing Address
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Address Line | 515 E COURT ST STE 200
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City | SEGUIN
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State | TX
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Zip | 78155-5750
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Country | US
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Telephone | 830-372-0550
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Fax | 830-372-4372
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Authorized Official
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Title or Position | OWNER
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Name | DR. LEIGH ANN HOLUB
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Credential | OD
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Telephone | 830-372-0550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 6746-TG
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License Number State | TX
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