MEDICARE: RACHEL ANNE BUTLER OD

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	10559T	TX

General Provider Information

NPI Number	:	1669107561
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL ANNE BUTLER OD

Provider Business Mailing Address
First Line	:	2020 PEMBROKE DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76110-1236
Country	:	US
Telephone Number	:	817-690-4425
Fax Number	:

Provider Business Practice Location Address
First Line	:	2301 W PARK ROW DR # D
Second Line	:
City	:	PANTEGO
State	:	TX
Zip	:	76013-3346
Country	:	US
Telephone Number	:	817-460-5333
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/24/2022
Last Update Date	:	07/24/2022

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Directions to “ RACHEL ANNE BUTLER OD” Practice Location

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