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NPI Code Detail

MEDICARE: ROANOKE FAMILY EYECARE CENTER, PLLC

MEDICARE: ROANOKE FAMILY EYECARE CENTER, 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
1152W00000XOptometrist

General Provider Information

NPI Number : 1376318212
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROANOKE FAMILY EYECARE CENTER, PLLC
Provider Business Mailing Address
First Line : 1485 PRIMROSE PL
Second Line :
City : HASLET
State : TX
Zip : 76052-1813
Country : US
Telephone Number : 817-757-9271
Fax Number :
Provider Business Practice Location Address
First Line : 1228 N HIGHWAY 377
Second Line :
City : ROANOKE
State : TX
Zip : 76262-9122
Country : US
Telephone Number : 682-831-9335
Fax Number :
Authorized Official
Title or Position : OPTOMETRIST/OWNER
Name : DR. BARJINDER GILL
Credential : OD
Telephone Number : 817-757-9271
Provider Enumeration Date : 11/21/2023
Last Update Date : 01/12/2024

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