Organization
EYESITE FAMILY VISION INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAHROKH ROUHANI O.D. (PRESIDENT)
(512) 467-2020
Entity
Organization
Contact information
Practice address
5775 AIRPORT BLVD STE 400B, AUSTIN, TX 78752-4218
(512) 467-2020
Mailing address
5775 AIRPORT BLVD, STE 400 B, AUSTIN, TX 78752-4214
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
7169T
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
192604001
—
TX
Enumeration date
11/16/2010
Last updated
04/07/2011
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