MEDICARE: GREEN EYE ASSOCIATES, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	5972	TX

General Provider Information

NPI Number	:	1063833242
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREEN EYE ASSOCIATES, PLLC

Provider Business Mailing Address
First Line	:	201 COLONNADE PKWY
Second Line	:
City	:	WOODWAY
State	:	TX
Zip	:	76712
Country	:	US
Telephone Number	:	254-752-0471
Fax Number	:	254-237-5401

Provider Business Practice Location Address
First Line	:	201 COLONNADE PKWY
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76712-6174
Country	:	US
Telephone Number	:	254-752-0471
Fax Number	:	254-237-5401

Authorized Official
Title or Position	:	OWNER, OPTOMETRIST
Name	:	DR. LEIGH ANNE GREEN
Credential	:	O.D.
Telephone Number	:	254-752-0471

Provider Enumeration Date	:	12/14/2013
Last Update Date	:	01/15/2026

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