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NPI Code Detail

MEDICARE: DR. LESA MUELLER KLEIN O.D.

MEDICARE: DR. LESA MUELLER KLEIN O.D.
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
1152W00000XOptometristT02815MO
2152WP0200XPediatric OptometristT02815MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770545022
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LESA MUELLER KLEIN O.D.
Provider Business Mailing Address
First Line : 1 UNIVERSITY BLVD
Second Line : 153 MARILLAC HALL
City : SAINT LOUIS
State : MO
Zip : 63121-4400
Country : US
Telephone Number : 314-516-5131
Fax Number : 314-516-5507
Provider Business Practice Location Address
First Line : 7800 NATURAL BRIDGE RD
Second Line : 1 UNIVERSITY BLVD
City : SAINT LOUIS
State : MO
Zip : 63121-4617
Country : US
Telephone Number : 314-516-5131
Fax Number : 314-516-5507
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2006
Last Update Date : 10/02/2014

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