MEDICARE: LESLIE YULIANA COUOH

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	11666	TX

General Provider Information

NPI Number	:	1700716347
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LESLIE YULIANA COUOH

Provider Business Mailing Address
First Line	:	5044 TENNYSON PKWY
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-2952
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5044 TENNYSON PKWY
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-2952
Country	:	US
Telephone Number	:	972-378-4104
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2026
Last Update Date	:	06/23/2026

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