Provider Demographics
NPI:1215903620
Name:BARCACEL, LEANDRO A (OD)
Entity type:Individual
Prefix:DR
First Name:LEANDRO
Middle Name:A
Last Name:BARCACEL
Suffix:
Gender:M
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 230208
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77223-0208
Mailing Address - Country:US
Mailing Address - Phone:713-923-2890
Mailing Address - Fax:713-923-2075
Practice Address - Street 1:7103 LAWNDALE ST
Practice Address - Street 2:SUITE 270
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77023-4248
Practice Address - Country:US
Practice Address - Phone:713-923-2890
Practice Address - Fax:713-923-2075
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3262TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX019573702Medicaid
TX0195737-02Medicaid
TX0195737-02Medicaid
TX019573702Medicaid