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Organization
AUSTIN EYE CLINIC ASSOCIATION
Active
Organization
AUSTIN EYE CLINIC ASSOCIATION
Active
Parent organization
AUSTIN EYE CLINIC ASSOCIATION
Other names
Austin Eye Laser and Surgicenter
Organization subpart
Yes
Provider details
NPI number
Legal business name
AUSTIN EYE CLINIC ASSOCIATION
Authorized official
SHANNON M WONG MD (CEO)
(512) 250-2020
Entity
Organization
Contact information
Practice address
11901 JOLLYVILLE RD, AUSTIN, TX 78759-2303
(512) 250-2020
(512) 250-2612
Mailing address
11901 JOLLYVILLE RD, AUSTIN, TX 78759-2303
(512) 250-2020
(512) 250-2612
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
007153
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HH1529
BCBS TX
TX
Enumeration date
10/03/2005
Last updated
09/08/2020
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