MEDICARE: DR. DREW APPLING 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	152WC0802X	Corneal and Contact Management Optometrist	TX02684TG	TX

General Provider Information

NPI Number	:	1861551889
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DREW APPLING O.D.

Provider Business Mailing Address
First Line	:	145 CREST CANYON DR
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76108-9641
Country	:	US
Telephone Number	:	817-989-2525
Fax Number	:

Provider Business Practice Location Address
First Line	:	4400 BRYANT IRVIN RD
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76132-1064
Country	:	US
Telephone Number	:	817-989-2525
Fax Number	:

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

Provider Enumeration Date	:	12/06/2006
Last Update Date	:	07/08/2007

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