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Organization
MODERN FAMILY VISION
Active
Organization
MODERN FAMILY VISION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY E LEAZURE OD (OWNER)
(972) 396-2021
Entity
Organization
Contact information
Practice address
906 W MCDERMOTT DR, SUITE 120, ALLEN, TX 75013-6510
(972) 396-2021
(972) 396-0242
Mailing address
906 W MCDERMOTT DR, SUITE 120, ALLEN, TX 75013-6510
(972) 396-2021
(972) 396-0242
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5198TG
TX
Other
Enumeration date
04/18/2008
Last updated
04/18/2008
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