MEDICARE: THE HERITAGE EYECARE CENTER

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

General Provider Information

NPI Number	:	1548042138
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE HERITAGE EYECARE CENTER

Provider Business Mailing Address
First Line	:	1485 PRIMROSE PL
Second Line	:
City	:	HASLET
State	:	TX
Zip	:	76052-1813
Country	:	US
Telephone Number	:	817-757-9271
Fax Number	:

Provider Business Practice Location Address
First Line	:	9555 HARMON RD
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76177-7517
Country	:	US
Telephone Number	:	817-757-9271
Fax Number	:

Authorized Official
Title or Position	:	OPTOMETRIST/OWNER
Name	:	DR. BARJINDER SINGH GILL
Credential	:	O.D
Telephone Number	:	817-757-9271

Provider Enumeration Date	:	10/18/2023
Last Update Date	:	10/18/2023

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Directions to “THE HERITAGE EYECARE CENTER ” Practice Location

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