Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 9170T | TX |
NPI | 1003339755 |
---|---|
Provider Name | Meagan Nicole Legrand |
First Address | League City, TX 77573-7373 |
Second Address | League City, TX 77573-7373 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2017 |
Last Update Date | 01/08/2020 |