Provider Demographics
NPI:1578855417
Name:M BELLO, OD., P.C.
Entity Type:Organization
Organization Name:M BELLO, OD., P.C.
Other - Org Name:VISION CONCEPTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BELLO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:254-865-7979
Mailing Address - Street 1:113 N LUTTERLOH AVE
Mailing Address - Street 2:
Mailing Address - City:GATESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76528-1421
Mailing Address - Country:US
Mailing Address - Phone:254-865-7979
Mailing Address - Fax:254-865-2605
Practice Address - Street 1:113 N LUTTERLOH AVE
Practice Address - Street 2:
Practice Address - City:GATESVILLE
Practice Address - State:TX
Practice Address - Zip Code:76525-1421
Practice Address - Country:US
Practice Address - Phone:254-865-7979
Practice Address - Fax:254-865-2605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-11
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4428T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX108385100OtherFIRST CARE
TX20463OtherSCOTT & WHITE
TXP00109892OtherRAILROAD MEDICARE
TXU45767Medicare UPIN
TX1190190001Medicare NSC
TX108385100OtherFIRST CARE