MEDICARE: DR. RICHARD A SYLVESTER O.D.,M.A.T.,P.A.

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	7005346	TX
2	152WL0500X	Low Vision Rehabilitation Optometrist	7005346	TX
3	152WP0200X	Pediatric Optometrist	7005346	TX
4	152WS0006X	Sports Vision Optometrist	7005346	TX
5	152WX0102X	Occupational Vision Optometrist	7005346	TX
6	332H00000X	Eyewear Supplier	7005346	TX
7	152W00000X	Optometrist	5346	TX

General Provider Information

NPI Number	:	1376688507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD A SYLVESTER O.D.,M.A.T.,P.A.

Provider Business Mailing Address
First Line	:	8614 WESTWOOD CENTER DR FL 9
Second Line	:
City	:	VIENNA
State	:	VA
Zip	:	22182-2442
Country	:	US
Telephone Number	:	703-847-8899
Fax Number	:

Provider Business Practice Location Address
First Line	:	1650 N LAKE FOREST DR STE 100
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75071-7668
Country	:	US
Telephone Number	:	972-369-1411
Fax Number	:	972-369-1197

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	08/25/2022

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