MEDICARE: BOGUSLAW SWITALSKI

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	7644T	TX

General Provider Information

NPI Number	:	1508170341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BOGUSLAW SWITALSKI

Provider Business Mailing Address
First Line	:	6469 RIDGEMONT DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75214-1657
Country	:	US
Telephone Number	:	954-993-6543
Fax Number	:

Provider Business Practice Location Address
First Line	:	2401 S STEMMONS FWY
Second Line	:	SUITE 2210
City	:	LEWISVILLE
State	:	TX
Zip	:	75067-8775
Country	:	US
Telephone Number	:	972-459-4908
Fax Number	:

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

Provider Enumeration Date	:	08/04/2010
Last Update Date	:	03/03/2015

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Directions to “ BOGUSLAW SWITALSKI ” Practice Location

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