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Organization

TEXOMA FAMILY EYE CARE CLINIC PA

Active
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Organization

TEXOMA FAMILY EYE CARE CLINIC PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LEEANN MOLL-LEAR O.D. (OWNER)
(940) 696-9072
Entity
Organization

Contact information

Practice address
4102 JACKSBORO HWY, SUITE 100, WICHITA FALLS, TX 76302-2747
(940) 696-9072
(940) 761-1115
Mailing address
4102 JACKSBORO HWY, SUITE 100, WICHITA FALLS, TX 76302-2747
(940) 696-9072
(940) 761-1115

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3892T
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0022FC
BLUE CROSS BLUE SHIELD
TX
05
—
0933137-01
—
TX
01
—
8F0247
REFERRING PROVIDER ID
TX
01
—
MO001348245
HIGHMARK BCBS/ALCOA
TX
Enumeration date
10/27/2006
Last updated
05/09/2008
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