Provider Demographics
NPI:1679756662
Name:MILLS COUNTY EYE CARE P. C.
Entity Type:Organization
Organization Name:MILLS COUNTY EYE CARE P. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:CARYNE
Authorized Official - Last Name:BARTEK
Authorized Official - Suffix:
Authorized Official - Credentials:O D
Authorized Official - Phone:325-648-2040
Mailing Address - Street 1:PO BOX 669
Mailing Address - Street 2:1020 FOURTH ST.
Mailing Address - City:GOLDTHWAITE
Mailing Address - State:TX
Mailing Address - Zip Code:76844-0669
Mailing Address - Country:US
Mailing Address - Phone:325-648-2040
Mailing Address - Fax:
Practice Address - Street 1:1020 FOURTH ST
Practice Address - Street 2:
Practice Address - City:GOLDTHWAITE
Practice Address - State:TX
Practice Address - Zip Code:76844-0669
Practice Address - Country:US
Practice Address - Phone:325-648-2040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-12
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3879160001Medicare NSC
TX00013SMedicare PIN