Provider Demographics
NPI:1124861307
Name:MACLENNAN, PAISLEY (OD)
Entity type:Individual
Prefix:
First Name:PAISLEY
Middle Name:
Last Name:MACLENNAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 416
Mailing Address - Street 2:
Mailing Address - City:LINDSAY
Mailing Address - State:TX
Mailing Address - Zip Code:76250-0416
Mailing Address - Country:US
Mailing Address - Phone:940-284-3817
Mailing Address - Fax:
Practice Address - Street 1:2020 W HIGHWAY 82
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:TX
Practice Address - Zip Code:76240-2051
Practice Address - Country:US
Practice Address - Phone:940-612-2020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11202152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist