MEDICARE: CROSS SORIANO OPTOMETRY PARTNERSHIP

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	:	1265240931
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CROSS SORIANO OPTOMETRY PARTNERSHIP

Provider Business Mailing Address
First Line	:	109 CARROLL ST STE 111
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76107-2068
Country	:	US
Telephone Number	:	817-646-3449
Fax Number	:	817-549-4503

Provider Business Practice Location Address
First Line	:	109 CARROLL ST STE 111
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76107-2068
Country	:	US
Telephone Number	:	817-646-3449
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER/OPTOMETRIST
Name	:	DR. MATT ANTHONY MACAYAN SORIANO
Credential	:	OD
Telephone Number	:	224-623-2846

Provider Enumeration Date	:	12/26/2024
Last Update Date	:	06/11/2026

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