Organization
EYE CLINIC OF AUSTIN
Active
Other names
Eye Clinic of Austin
Organization subpart
No
Provider details
NPI number
Authorized official
MO LIVERMORE (PRACTICE ADMINISTRATOR)
(512) 427-1107
Entity
Organization
Contact information
Practice address
3410 FAR WEST BLVD STE 140, AUSTIN, TX 78731
(512) 427-1107
(512) 427-1208
Mailing address
3410 FAR WEST BLVD STE 140, AUSTIN, TX 78731
(512) 427-1107
(512) 427-1208
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
06143TG
TX
207W00000X
Ophthalmology Physician
Primary
F4863
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
313929702
—
TX
05
—
PENDING
—
TX
Enumeration date
07/17/2012
Last updated
10/05/2021
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