Provider Demographics
NPI:1598850133
Name:MAKLER, EDWARD A (OD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:A
Last Name:MAKLER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1332 S. PLANO ROAD, #112
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081
Mailing Address - Country:US
Mailing Address - Phone:972-690-4466
Mailing Address - Fax:972-680-9518
Practice Address - Street 1:1332 S. PLANO ROAD, #112
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081
Practice Address - Country:US
Practice Address - Phone:972-690-4466
Practice Address - Fax:972-680-9518
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2138TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX112447101Medicaid
T14559Medicare UPIN
TX112447101Medicaid
TX0185340001Medicare NSC