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NPI Code Detail

MEDICARE: ELLE REQUINA

MEDICARE: ELLE REQUINA
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
1156FX1800XOptician

General Provider Information

NPI Number : 1265368245
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLE REQUINA
Provider Business Mailing Address
First Line : 1535 FALLCREEK CT
Second Line :
City : ALLEN
State : TX
Zip : 75002-4941
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2662 W LUCAS RD
Second Line :
City : LUCAS
State : TX
Zip : 75002-7513
Country : US
Telephone Number : 469-675-8559
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2026
Last Update Date : 06/18/2026

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Directions to “ ELLE REQUINA ” Practice Location

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