Organization
EYE CLINIC OF AUSTIN PLLC THOMAS HENDERSON SOLE MBR
Active
Other names
Eye Clinic of Austin
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS THOMAN HENDERSON MD (PRESIDENT CEO)
(512) 427-1100
Entity
Organization
Contact information
Practice address
3410 FAR WEST BLVD, SUITE 140, AUSTIN, TX 78731-3167
(512) 427-1100
(512) 427-1207
Mailing address
3410 FAR WEST BLVD, SUITE 140, AUSTIN, TX 78731-3167
(512) 427-1100
(512) 427-1208
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
F4863
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115509501
—
TX
01
—
180008032
MEDICARE RAILROAD GRP
TX
01
—
612710001
NATIONAL SUPPLIER CLEARIN
TX
05
—
93945601
—
TX
Enumeration date
09/29/2006
Last updated
03/28/2012
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