MEDICARE: RICHARD K BARTLETT OD PA

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	73116	TX

General Provider Information

NPI Number	:	1750608212
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHARD K BARTLETT OD PA

Provider Business Mailing Address
First Line	:	2014 JUSTIN RD
Second Line	:	SUITE 104
City	:	HIGHLAND VILLAGE
State	:	TX
Zip	:	75077-7161
Country	:	US
Telephone Number	:	972-966-6868
Fax Number	:

Provider Business Practice Location Address
First Line	:	2014 JUSTIN RD
Second Line	:	SUITE 104
City	:	HIGHLAND VILLAGE
State	:	TX
Zip	:	75077-7161
Country	:	US
Telephone Number	:	972-966-6868
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RICHARD K BARTLETT
Credential	:	OD
Telephone Number	:	972-966-6868

Provider Enumeration Date	:	04/23/2010
Last Update Date	:	04/23/2010

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