| Le Opti Tech Inc | |
|
708 N Macarthur Blvd Irving TX 75061-7355 | |
| (972) 254-0033 | |
| (972) 254-0055 |
| Full Name | Le Opti Tech Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 708 N Macarthur Blvd, Irving, Texas |
| Authorized Official Name and Position | Bradley Miles Kardatzke (PRESIDENT OWNER) |
| Authorized Official Contact | 9722540033 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Le Opti Tech Inc Po Box 153328 Irving TX 75015-3328 Ph: (972) 254-0033 | Le Opti Tech Inc 708 N Macarthur Blvd Irving TX 75061-7355 Ph: (972) 254-0033 |
| NPI Number | 1023008687 |
|---|---|
| Provider Enumeration Date | 10/25/2005 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 6305803776 |
|---|---|
| Medicare Enrollment ID | O20041216000989 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023008687 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Bradley M Kardatzke |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1104816545 PECOS PAC ID: 9931166303 Enrollment ID: I20041216001004 |
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