MEDICARE: DR. EDWARD A. MAKLER O.D.

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	2138TG	TX

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

General Provider Information

NPI Number	:	1598850133
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD A. MAKLER O.D.

Provider Business Mailing Address
First Line	:	1332 S. PLANO ROAD, #112
Second Line	:
City	:	RICHARDSON
State	:	TX
Zip	:	75081
Country	:	US
Telephone Number	:	972-690-4466
Fax Number	:	972-680-9518

Provider Business Practice Location Address
First Line	:	1332 S. PLANO ROAD, #112
Second Line	:
City	:	RICHARDSON
State	:	TX
Zip	:	75081
Country	:	US
Telephone Number	:	972-690-4466
Fax Number	:	972-680-9518

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

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	01/19/2016

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