MEDICARE: EYE & CONTACT LENS ASSOCIATES OF NORTH TEXAS PLLC

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	:	1235844945
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYE & CONTACT LENS ASSOCIATES OF NORTH TEXAS PLLC

Provider Business Mailing Address
First Line	:	18111 PRESTON RD STE 180
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75252-6009
Country	:	US
Telephone Number	:	972-248-0202
Fax Number	:	972-248-1711

Provider Business Practice Location Address
First Line	:	18111 PRESTON RD STE 180
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75252-6009
Country	:	US
Telephone Number	:	972-248-0202
Fax Number	:	972-248-1711

Authorized Official
Title or Position	:	MANAGING OD
Name	:	MURRAY H JOHNSON
Credential	:	OD
Telephone Number	:	972-248-0202

Provider Enumeration Date	:	01/17/2023
Last Update Date	:	01/17/2023

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