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General NPI Number Information
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NPI Number | 1174745301
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Entity Type | Organization
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Legal Business Name | SOUTHWEST OPHTHALMOLOGY ASSOCIATES, PLLC
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 07/11/2011
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Provider Practice Location Address
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Address Line | 910 N DAVIS DRIVE SUITE 100
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City | ARLINGTON
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State | TX
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Zip | 76012-3200
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Country | US
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Telephone | 817-265-8525
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Fax | 817-860-6056
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Provider Business Mailing Address
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Address Line | 910 N DAVIS DRIVE SUITE 100
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City | ARLINGTON
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State | TX
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Zip | 76012-3200
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Country | US
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Telephone | 817-265-8525
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Fax | 817-860-6056
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Authorized Official
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Title or Position | OWNER
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Name | DR. RONALD MARTIN BARKE
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Credential | M.D.
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Telephone | 817-265-8525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | J0439
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License Number State | TX
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