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General NPI Number Information
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NPI Number | 1689761249
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Entity Type | Individual
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Provider Name | MATTHEW BASHOVER O.D.
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Gender | Male
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 3990 N COLLINS ST STE 102
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City | ARLINGTON
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State | TX
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Zip | 76005-4580
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Country | US
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Telephone | 817-261-2020
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Fax | 817-261-2262
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Provider Business Mailing Address
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Address Line | 6702 KINGSHOLLOW DR
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City | DALLAS
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State | TX
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Zip | 75248-2923
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Country | US
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Telephone | 972-385-7050
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3315-T
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License Number State | TX
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