Provider Demographics
NPI:1154631299
Name:RICHARD A. SYLVESTER M.A.T., O.D., P.A
Entity type:Organization
Organization Name:RICHARD A. SYLVESTER M.A.T., O.D., P.A
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:SYLVESTER
Authorized Official - Suffix:
Authorized Official - Credentials:OD , MAT, PA
Authorized Official - Phone:972-334-9944
Mailing Address - Street 1:4300 LEGACY DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-0813
Mailing Address - Country:US
Mailing Address - Phone:972-334-9944
Mailing Address - Fax:972-334-9011
Practice Address - Street 1:4300 LEGACY DR
Practice Address - Street 2:SUITE 105
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-0813
Practice Address - Country:US
Practice Address - Phone:972-334-9944
Practice Address - Fax:972-334-9011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT5346152W00000X, 152WC0802X, 152WX0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Multi-Specialty
No152WX0102XEye and Vision Services ProvidersOptometristOccupational VisionGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU51962Medicare UPIN