MEDICARE: CONTACT LENS CENTER INC

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

General Provider Information

NPI Number	:	1093017667
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONTACT LENS CENTER INC

Provider Business Mailing Address
First Line	:	1514 E BELT LINE RD
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75006-6369
Country	:	US
Telephone Number	:	972-242-2020
Fax Number	:	972-242-2020

Provider Business Practice Location Address
First Line	:	1514 E BELT LINE RD
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75006-6369
Country	:	US
Telephone Number	:	972-242-2020
Fax Number	:	972-242-2020

Authorized Official
Title or Position	:	OWNER
Name	:	BELINDA WEGMAN
Credential	:	OD
Telephone Number	:	972-242-2020

Provider Enumeration Date	:	12/02/2010
Last Update Date	:	10/20/2023

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