MEDICARE: FOCAL POINT OPTOMETRICS 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
1	152W00000X	Optometrist	L1171093	MI

General Provider Information

NPI Number	:	1518112846
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOCAL POINT OPTOMETRICS PLLC

Provider Business Mailing Address
First Line	:	3050 UNION LAKE RD
Second Line	:	SUITE 3B
City	:	COMMERCE TOWNSHIP
State	:	MI
Zip	:	48382-4509
Country	:	US
Telephone Number	:	248-360-4300
Fax Number	:	248-360-4503

Provider Business Practice Location Address
First Line	:	3050 UNION LAKE RD
Second Line	:	SUITE 3B
City	:	COMMERCE TOWNSHIP
State	:	MI
Zip	:	48382-4509
Country	:	US
Telephone Number	:	248-360-4300
Fax Number	:	248-360-4503

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	DR. DEBRA E BOURDEAU
Credential	:	O.D.
Telephone Number	:	248-360-4300

Provider Enumeration Date	:	12/01/2008
Last Update Date	:	01/05/2009

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