MEDICARE: DR. MARTIN JOSEPH BAUMOHL 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	4949TG	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	:	1629071865
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARTIN JOSEPH BAUMOHL O.D.

Provider Business Mailing Address
First Line	:	2616 FM 2920 RD
Second Line	:	STE. I
City	:	SPRING
State	:	TX
Zip	:	77388-3589
Country	:	US
Telephone Number	:	281-353-8300
Fax Number	:	281-353-7694

Provider Business Practice Location Address
First Line	:	2616 FM 2920 RD
Second Line	:	STE. I
City	:	SPRING
State	:	TX
Zip	:	77388-3589
Country	:	US
Telephone Number	:	281-353-8300
Fax Number	:	281-353-7694

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	10/26/2015

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