Patmick LLC

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

DRO166 Issued in TX

Legal business name

PATMICK LLC

Practice address

2255 8TH Ave
Fort Worth, TX 76110-1812

Phone

(817) 370-6118

Fax

(817) 370-7118

NPI assigned

Dec 26, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Michael Jack Bradley

Title

Principal

Phone

(817) 370-6118

Specialties & licenses 1

Addresses

Other names 1

• Patrick Optical Former legal business name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1198627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501113600000",
    "number": "1669656799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2255 8TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761101812",
            "telephone_number": "817-370-6118",
            "fax_number": "817-370-7118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 8TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761101812",
            "telephone_number": "817-370-6118",
            "fax_number": "817-370-7118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATMICK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-26",
        "last_updated": "2017-07-27",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JACK",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "817-370-6118",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "TX",
            "license": "DRO166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Patrick Optical",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Eyewear Supplier in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Eyewear Supplier in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.