Individual
LISA MICHELLE PREJEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
2910 MARKET LOOP, TEMPLE, TX 76502-1855
(254) 778-6165
Mailing address
531 WESTBURY LN, GEORGETOWN, TX 78633-4465
(979) 236-8838
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
9045TG
TX
152W00000X
Optometrist
R-258
AL
Other
Enumeration date
08/24/2017
Last updated
08/24/2017
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