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Individual

DAVID GARDINER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
13201 RANCH ROAD 620 N STE 100 BLDG R, AUSTIN, TX 78717-1028
(512) 336-2020
Mailing address
13201 RANCH ROAD 620 N STE 100 BLDG R, AUSTIN, TX 78717-1028
(512) 336-2020

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5125T
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5125T
STATE LICENSE
TX
01
W0101075
DPS LICENSE
TX
Enumeration date
09/24/2006
Last updated
03/07/2023
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