=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811953938
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DAVID HARAKAL O.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/26/2006
-----------------------------------------------------
Last Update Date | 03/27/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1088 HOWERTOWN RD
-----------------------------------------------------
City | CATASAUQUA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18032-1615
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-264-4664
-----------------------------------------------------
Fax | 610-264-5202
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3129 OXFORD CIR S
-----------------------------------------------------
City | ALLENTOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18104-2840
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-395-9242
-----------------------------------------------------
Fax | 610-395-9242
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | OEG 000181
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------