Organization
LAKELINE VISION, P.C.
Active
Other names
Lakeline Vision Source
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE L WIGGINS (CREDENTIALING MANAGER)
(512) 918-3937
Entity
Organization
Contact information
Practice address
3419 EL SALIDO PKWY STE 100, CEDAR PARK, TX 78613-5639
(512) 918-3937
(512) 918-2028
Mailing address
3419 EL SALIDO PKWY STE 100, CEDAR PARK, TX 78613-5639
(512) 918-3937
(512) 918-2028
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
05/28/2006
Last updated
10/05/2020
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