Provider Demographics
NPI:1982694394
Name:BARTEK, MELANIE CARYNE (O D)
Entity Type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:CARYNE
Last Name:BARTEK
Suffix:
Gender:F
Credentials:O D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:325-648-3600
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:325-648-3600
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-26
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5958TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX83074EMedicare ID - Type Unspecified
TXU82404Medicare UPIN