Provider Demographics
NPI:1154546018
Name:LITTLE ELM EYE CARE, P.A.
Entity type:Organization
Organization Name:LITTLE ELM EYE CARE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BUBELA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:972-292-0900
Mailing Address - Street 1:1200 E ELDORADO PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-5582
Mailing Address - Country:US
Mailing Address - Phone:972-292-0900
Mailing Address - Fax:972-292-0908
Practice Address - Street 1:1200 E ELDORADO PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:LITTLE ELM
Practice Address - State:TX
Practice Address - Zip Code:75068-5582
Practice Address - Country:US
Practice Address - Phone:972-292-0900
Practice Address - Fax:972-292-0908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5926TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5277800001Medicare NSC