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NPI Code Detail

MEDICARE: MICHAEL BOLLISH, O.D. P.C.

MEDICARE: MICHAEL BOLLISH, O.D. P.C.
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
1152W00000XOptometrist3918TX

General Provider Information

NPI Number : 1396924494
Entity Type Code : Organization
Provider Name (Legal Business Name) : MICHAEL BOLLISH, O.D. P.C.
Provider Business Mailing Address
First Line : 6850 N SHILOH ROAD SUITE T
Second Line :
City : GARLAND
State : TX
Zip : 75044-2918
Country : US
Telephone Number : 972-414-0444
Fax Number : 972-414-5663
Provider Business Practice Location Address
First Line : 6850 NORTH SHILOH ROAD STE T
Second Line :
City : GARLAND
State : TX
Zip : 75044-2918
Country : US
Telephone Number : 972-414-0444
Fax Number : 972-414-5663
Authorized Official
Title or Position : PRESIDENT
Name : DR. MICHAEL JAMES BOLLISH
Credential : O.D.
Telephone Number : 972-414-0444
Provider Enumeration Date : 10/25/2007
Last Update Date : 04/15/2008

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