Provider Demographics
NPI:1740331180
Name:LABBE OPTOMETRIC CLINIC,INC.
Entity type:Organization
Organization Name:LABBE OPTOMETRIC CLINIC,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:LABBE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:940-549-7011
Mailing Address - Street 1:PO BOX 1470
Mailing Address - Street 2:709 OAK ST.
Mailing Address - City:GRAHAM
Mailing Address - State:TX
Mailing Address - Zip Code:76450-7470
Mailing Address - Country:US
Mailing Address - Phone:940-549-7011
Mailing Address - Fax:940-549-0252
Practice Address - Street 1:3130 LAWRENCE RD
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76308-1607
Practice Address - Country:US
Practice Address - Phone:940-696-8028
Practice Address - Fax:940-549-0252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3149 TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXT14306 TXMedicare UPIN
TX00E49EMedicare ID - Type Unspecified