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General NPI Number Information
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NPI Number | 1821128091
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Entity Type | Individual
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Provider Name | RICHARD H LE O.D.
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Gender | Male
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2112 GREEN OAKS RD SUITE B
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City | FORT WORTH
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State | TX
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Zip | 76116-1705
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Country | US
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Telephone | 817-738-9600
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Fax | 817-738-9650
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Provider Business Mailing Address
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Address Line | PO BOX 630856
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City | IRVING
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State | TX
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Zip | 75063-0136
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Country | US
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Telephone | 817-738-9600
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Fax | 817-738-9650
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 4994T
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License Number State | TX
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