Modern Family Vision

Primary specialty

OptometristTaxonomy code 152W00000X

License

5198TG Issued in TX

Legal business name

MODERN FAMILY VISION

Practice address

906 W McDermott Dr
Suite 120
Allen, TX 75013-6510

Phone

(972) 396-2021

Fax

(972) 396-0242

NPI assigned

Apr 18, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mary E Leazure, ODNPI 1104835693

Title

Owner

Phone

(972) 396-2021

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mary E Leazure, O.D.

  • Optometrist
  • Allen, TX
  • NPI 1104835693
  Medicare reassignment NPD Authorized official
• Janet Castro, O.D.

  • Optometrist
  • Frisco, TX
  • NPI 1750541520
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1208476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208476800000",
    "number": "1336313592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 W MCDERMOTT DR",
            "address_2": "SUITE 120",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750136510",
            "telephone_number": "972-396-2021",
            "fax_number": "972-396-0242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 W MCDERMOTT DR",
            "address_2": "SUITE 120",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750136510",
            "telephone_number": "972-396-2021",
            "fax_number": "972-396-0242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN FAMILY VISION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-18",
        "last_updated": "2008-04-18",
        "status": "A",
        "authorized_official_last_name": "LEAZURE",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-396-2021",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5198TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mizan Counseling, PLLC
• Mizuno Family Dentistry PLLC
• Daigo Mizuno, D.D.S.
• Moataz Pharmacuticals
• Mobile Vision Care, Inc.
• Sunil Jashvantlal Modi, M.D.
• Amanda Rose Modrovsky
• Mohammad Azad MD PA
• Khalid Mohammad, MD
• Brittany Mohn, DC

• Optometrist in Allen, TX
• Providers in Allen, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.