Provider Demographics
NPI:1619178332
Name:NORTH TEXAS TOTAL EYE CARE P A
Entity Type:Organization
Organization Name:NORTH TEXAS TOTAL EYE CARE P A
Other - Org Name:TOTAL EYE CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:OPTOMETRIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:DRISCOLL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:817-656-5222
Mailing Address - Street 1:6114 COLLEYVILLE BLVD
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-6221
Mailing Address - Country:US
Mailing Address - Phone:817-416-0333
Mailing Address - Fax:
Practice Address - Street 1:6114 COLLEYVILLE BLVD
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-5866
Practice Address - Country:US
Practice Address - Phone:817-416-0333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4015TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00Z626OtherMEDICARE
TXCH7421OtherRR MEDICARE
TXCH7421OtherRR MEDICARE