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General NPI Number Information
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NPI Number | 1720413958
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Entity Type | Organization
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Legal Business Name | PATRICK M LEAS, O.D,,INC.
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Dates
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Enumeration Date | 09/06/2013
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Last Update Date | 05/06/2014
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Provider Practice Location Address
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Address Line | 3818 S NEW BRAUNFELS AVE
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City | SAN ANTONIO
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State | TX
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Zip | 78223-1720
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Country | US
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Telephone | 210-534-2244
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Fax | 210-532-8355
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Provider Business Mailing Address
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Address Line | 3818 S NEW BRAUNFELS AVE
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City | SAN ANTONIO
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State | TX
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Zip | 78223-1720
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Country | US
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Telephone | 210-534-2244
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Fax | 210-532-8355
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Authorized Official
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Title or Position | OWNER
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Name | PATRICK M LEAS
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Credential | O.D.
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Telephone | 210-534-2244
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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 | 3064
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License Number State | TX
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