Provider Demographics
NPI:1265683072
Name:DR DAVID J BAPTISTE THERAPEUTIC OPTOMETRIST, PLLC
Entity Type:Organization
Organization Name:DR DAVID J BAPTISTE THERAPEUTIC OPTOMETRIST, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:BAPTISTE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:817-637-2888
Mailing Address - Street 1:3515 SYCAMORE SCHOOL RD
Mailing Address - Street 2:SUITE 145
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76133-7825
Mailing Address - Country:US
Mailing Address - Phone:817-361-8440
Mailing Address - Fax:817-361-8335
Practice Address - Street 1:3515 SYCAMORE SCHOOL RD
Practice Address - Street 2:SUITE 145
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76133-7825
Practice Address - Country:US
Practice Address - Phone:817-361-8440
Practice Address - Fax:817-361-8335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-10
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6879T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty