MEDICARE: CATES OPTOMETRY LLC

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

General Provider Information

NPI Number	:	1184030074
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CATES OPTOMETRY LLC

Provider Business Mailing Address
First Line	:	2001 CHESTER BLVD
Second Line	:
City	:	RICHMOND
State	:	IN
Zip	:	47374-1200
Country	:	US
Telephone Number	:	765-966-0583
Fax Number	:

Provider Business Practice Location Address
First Line	:	2001 CHESTER BLVD
Second Line	:
City	:	RICHMOND
State	:	IN
Zip	:	47374-1200
Country	:	US
Telephone Number	:	317-645-5993
Fax Number	:

Authorized Official
Title or Position	:	OD
Name	:	ANGELA K CATES
Credential	:
Telephone Number	:	765-966-0583

Provider Enumeration Date	:	07/11/2014
Last Update Date	:	05/08/2019

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