MEDICARE: ESPECIALISTAS DE LA VISTA

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	156FX1800X	Optician

Other Identifiers

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

General Provider Information

NPI Number	:	1962532226
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ESPECIALISTAS DE LA VISTA

Provider Business Mailing Address
First Line	:	7107 LAWNDALE ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77023-4248
Country	:	US
Telephone Number	:	713-923-4148
Fax Number	:	713-923-2075

Provider Business Practice Location Address
First Line	:	7107 LAWNDALE ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77023-4248
Country	:	US
Telephone Number	:	713-923-4148
Fax Number	:	713-923-2075

Authorized Official
Title or Position	:	MANAGER
Name	:	DR. LEANDRO BARCACEL
Credential	:	O.D
Telephone Number	:	713-923-4148

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	08/22/2020

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Directions to “ESPECIALISTAS DE LA VISTA ” Practice Location

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