Provider Demographics
NPI:1194397521
Name:MORRIS, LESLIE (OD)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:MORRIS
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 1:372 TUDOR AVE
Mailing Address - Street 2:
Mailing Address - City:RIVER RIDGE
Mailing Address - State:LA
Mailing Address - Zip Code:70123-1346
Mailing Address - Country:US
Mailing Address - Phone:504-559-6109
Mailing Address - Fax:
Practice Address - Street 1:2700 LASALLE ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70113-2620
Practice Address - Country:US
Practice Address - Phone:504-215-7237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1931-867AT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist