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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
5717 BALCONES DR, AUSTIN, TX 78731
(512) 327-7000
(512) 314-1662
Mailing address
5717 BALCONES DR, AUSTIN, TX 78731-4203
(512) 327-7000
(512) 314-1662

Taxonomy

Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
G3889
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
083126501
TX
01
0J22H
MEDICARE ID
Enumeration date
06/13/2007
Last updated
01/03/2024
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