MEDICARE: DR. MARKITTA BARNETT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	7774T	TX
2	152W00000X	Optometrist	7281T	TX

General Provider Information

NPI Number	:	1114345675
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. MARKITTA BARNETT

Provider Business Mailing Address
First Line	:	PO BOX 592208
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78259-0160
Country	:	US
Telephone Number	:	210-223-1104
Fax Number	:	360-935-8560

Provider Business Practice Location Address
First Line	:	2490 7TH ST
Second Line	:	BLDG 372
City	:	FORT SAM HOUSTON
State	:	TX
Zip	:	78234-7613
Country	:	US
Telephone Number	:	210-223-1104
Fax Number	:	360-935-8560

Authorized Official
Title or Position	:	OWNER/ OPTOMETRIST
Name	:	DR. MARKITTA SAMONE BARNETT
Credential	:	O.D.
Telephone Number	:	210-592-3641

Provider Enumeration Date	:	04/02/2014
Last Update Date	:	07/02/2014

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Directions to “DR. MARKITTA BARNETT ” Practice Location

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