MEDICARE: EYE & OCULAR SURFACE CENTER OF TEXAS LLC

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	207W00000X	Ophthalmology Physician

General Provider Information

NPI Number	:	1285055905
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYE & OCULAR SURFACE CENTER OF TEXAS LLC

Provider Business Mailing Address
First Line	:	2900 PERSHING DR
Second Line	:	SUITE A
City	:	EL PASO
State	:	TX
Zip	:	79903-2403
Country	:	US
Telephone Number	:	915-538-3171
Fax Number	:

Provider Business Practice Location Address
First Line	:	2900 PERSHING DR
Second Line	:	SUITE A
City	:	EL PASO
State	:	TX
Zip	:	79903-2403
Country	:	US
Telephone Number	:	915-538-3171
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MARIO A DI PASCUALE
Credential	:	M.D,
Telephone Number	:	915-538-3171

Provider Enumeration Date	:	12/23/2013
Last Update Date	:	05/23/2014

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