MEDICARE: DR. ROBERT ANDREW SALCHAK OD

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	3983TG	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	82328Q	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1841258258
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT ANDREW SALCHAK OD

Provider Business Mailing Address
First Line	:	4511 SWEETWATER BLVD
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-3010
Country	:	US
Telephone Number	:	281-265-2020
Fax Number	:	281-265-2029

Provider Business Practice Location Address
First Line	:	4511 SWEETWATER BLVD
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-3010
Country	:	US
Telephone Number	:	281-491-1037
Fax Number	:	281-265-2029

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

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	09/04/2009

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