MEDICARE: DEMARCO EYECARE ASSOCIATES 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	152WC0802X	Corneal and Contact Management Optometrist

General Provider Information

NPI Number	:	1336612613
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEMARCO EYECARE ASSOCIATES PLLC

Provider Business Mailing Address
First Line	:	7555 N MESA ST
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-3505
Country	:	US
Telephone Number	:	915-833-1616
Fax Number	:

Provider Business Practice Location Address
First Line	:	7555 N MESA ST
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-3505
Country	:	US
Telephone Number	:	915-833-1616
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. JAMES JOSEPH DEMARCO JR.
Credential	:	OD
Telephone Number	:	915-833-1616

Provider Enumeration Date	:	01/09/2019
Last Update Date	:	01/09/2019

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