MEDICARE: MR. MATTHEW BASHOVER O.D.

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	3315-T	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	35787	OTHER	TX	DAVIS VISION
3	900917	OTHER	TX	BLOCK VISION

General Provider Information

NPI Number	:	1689761249
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MATTHEW BASHOVER O.D.

Provider Business Mailing Address
First Line	:	6702 KINGSHOLLOW DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75248-2923
Country	:	US
Telephone Number	:	972-385-7050
Fax Number	:

Provider Business Practice Location Address
First Line	:	3990 N COLLINS ST STE 102
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76005-4580
Country	:	US
Telephone Number	:	817-261-2020
Fax Number	:	817-261-2262

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

Provider Enumeration Date	:	10/06/2006
Last Update Date	:	09/02/2025

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Directions to “ MR. MATTHEW BASHOVER O.D.” Practice Location

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