MEDICARE: DR. MELANIE CARYNE BARTEK 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	5958TG	TX

General Provider Information

NPI Number	:	1982694394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELANIE CARYNE BARTEK O. D.

Provider Business Mailing Address
First Line	:	PO BOX 669
Second Line	:	1020 FOURTH ST.
City	:	GOLDTHWAITE
State	:	TX
Zip	:	76844-0669
Country	:	US
Telephone Number	:	325-648-2040
Fax Number	:	325-648-3600

Provider Business Practice Location Address
First Line	:	1020 FOURTH ST
Second Line	:
City	:	GOLDTHWAITE
State	:	TX
Zip	:	76844-0669
Country	:	US
Telephone Number	:	325-648-2040
Fax Number	:	325-648-3600

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

Provider Enumeration Date	:	10/26/2005
Last Update Date	:	03/12/2008

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