Organization
AVERY RANCH EYE CARE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRIS VINCENT O.D. (OPTOMETRIST)
(512) 528-8299
Entity
Organization
Contact information
Practice address
15004 AVERY RANCH BLVD, SUITE 103, AUSTIN, TX 78717-4600
(512) 528-8299
Mailing address
15004 AVERY RANCH BLVD, SUITE 103, AUSTIN, TX 78717-4600
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
07484TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07484TG
STATE OPTOMETRY LICENSE
TX
Enumeration date
10/24/2010
Last updated
10/24/2010
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