MEDICARE: OPHTHALMOLOGY CONSULTANTS PA

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	332H00000X	Eyewear Supplier
2	261QM2500X	Medical Specialty Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	00656N	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1427189968
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPHTHALMOLOGY CONSULTANTS PA

Provider Business Mailing Address
First Line	:	3200 N MACARTHUR BLVD
Second Line	:	SUITE 200
City	:	IRVING
State	:	TX
Zip	:	75062-4453
Country	:	US
Telephone Number	:	972-258-7979
Fax Number	:	972-570-5502

Provider Business Practice Location Address
First Line	:	3200 N MACARTHUR BLVD
Second Line	:	SUITE 200
City	:	IRVING
State	:	TX
Zip	:	75062-4453
Country	:	US
Telephone Number	:	972-258-7979
Fax Number	:	972-570-5502

Authorized Official
Title or Position	:	OWNER PRESIDENT
Name	:	EVERETT A MOODY
Credential	:	M.D.
Telephone Number	:	972-258-7979

Provider Enumeration Date	:	03/08/2007
Last Update Date	:	02/25/2022

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Directions to “OPHTHALMOLOGY CONSULTANTS PA ” Practice Location

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