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Organization
TEXAN EYE, PA
Active
Organization
TEXAN EYE, PA
Active
Parent organization
TEXAN EYE, PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
TEXAN EYE, PA
Authorized official
ROBERTA M MOORE (PATIENT ACCOUNT MANAGER)
(512) 314-1632
Entity
Organization
Contact information
Practice address
85 LOOP 150 WEST, BASTROP, TX 78602
(512) 303-7300
(512) 303-2148
Mailing address
5717 BALCONES DR, AUSTIN, TX 78731-4203
(512) 327-7000
(512) 314-1662
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
G3889
TX
207W00000X
Ophthalmology Physician
G3889
TX
332H00000X
Eyewear Supplier
G3889
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
085574301
—
TX
Enumeration date
09/21/2006
Last updated
06/02/2020
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