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NPI Code Detail

MEDICARE: AMEDCO TEXAS LLC

MEDICARE: AMEDCO 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
1152W00000XOptometristTX

General Provider Information

NPI Number : 1346517299
Entity Type Code : Organization
Provider Name (Legal Business Name) : AMEDCO TEXAS LLC
Provider Business Mailing Address
First Line : 8076 W SAHARA AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-7930
Country : US
Telephone Number : 877-881-0022
Fax Number : 702-255-0022
Provider Business Practice Location Address
First Line : 926 N WILCREST DR
Second Line :
City : HOUSTON
State : TX
Zip : 77079-3504
Country : US
Telephone Number : 713-984-9777
Fax Number : 713-463-7703
Authorized Official
Title or Position : CEO
Name : STEPHEN MCCORMACK
Credential :
Telephone Number : 877-881-0022
Provider Enumeration Date : 11/21/2011
Last Update Date : 11/21/2011

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Directions to “AMEDCO TEXAS LLC ” Practice Location

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