MEDICARE: DR. MELISSA ANN ASTON 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	06384TG	TX

General Provider Information

NPI Number	:	1619970431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELISSA ANN ASTON O.D.

Provider Business Mailing Address
First Line	:	8001 BOAT CLUB RD
Second Line	:	STE B
City	:	FORT WORTH
State	:	TX
Zip	:	76179-3636
Country	:	US
Telephone Number	:	817-750-2233
Fax Number	:	817-750-2266

Provider Business Practice Location Address
First Line	:	8001 BOAT CLUB RD
Second Line	:	STE B
City	:	FORT WORTH
State	:	TX
Zip	:	76179-3636
Country	:	US
Telephone Number	:	817-750-2233
Fax Number	:	817-750-2266

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	01/07/2008

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