Doctor Name: | MRS. MISTY BROOKE LEBLANC |
NPI Number: | 1093835464 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | O.D. |
License Number: | 6512TG |
Business Practice Address: | 1916 N Hobart St Pampa, TX - 790653413 |
Business Phone Number: | 8066692824 |
Business Fax Number: | |
Mailing Address: | 1429 N Zimmers St, PAMPA |
State: | TX |
Postal Code: | 790653923 |
Phone Number: | 8066881224 |
Fax Number: | |
NPI Enumeration Date: | 03/30/2007 |
NPI Last Update Date: | 09/21/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 152WC0802X |
License Number: | 6512TG |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Optometrist |
Taxonomy Specialization: | Corneal and Contact Management |
Taxonomy Definition: | The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea |