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General NPI Number Information
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NPI Number | 1346422664
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Entity Type | Organization
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Legal Business Name | LANCE LE OPTOMETRY SERVICES, P.C.
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Dates
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Enumeration Date | 11/28/2007
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Last Update Date | 12/12/2007
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Provider Practice Location Address
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Address Line | 14999 PRESTON RD SUITE 220D
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City | DALLAS
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State | TX
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Zip | 75254-9116
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Country | US
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Telephone | 972-663-3937
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Fax | 972-663-3938
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Provider Business Mailing Address
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Address Line | 14999 PRESTON RD SUITE 220D
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City | DALLAS
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State | TX
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Zip | 75254-9116
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Country | US
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Telephone | 972-663-3937
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Fax | 972-663-3938
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Authorized Official
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Title or Position | OWNER
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Name | DR. LANCE LE
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Credential | O.D.
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Telephone | 972-663-3937
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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 | 6124T
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License Number State | TX
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