Provider Demographics
NPI:1750608212
Name:RICHARD K BARTLETT OD PA
Entity type:Organization
Organization Name:RICHARD K BARTLETT OD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:K
Authorized Official - Last Name:BARTLETT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:972-966-6868
Mailing Address - Street 1:2014 JUSTIN RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HIGHLAND VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-7161
Mailing Address - Country:US
Mailing Address - Phone:972-966-6868
Mailing Address - Fax:
Practice Address - Street 1:2014 JUSTIN RD
Practice Address - Street 2:SUITE 104
Practice Address - City:HIGHLAND VILLAGE
Practice Address - State:TX
Practice Address - Zip Code:75077-7161
Practice Address - Country:US
Practice Address - Phone:972-966-6868
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-23
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73116152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty