Organization
AUSTIN OCULAR PROSTHETICS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CRAIG R PATAKY BCO (BOARD CERTIFIED OCULARIST)
(512) 452-3100
Entity
Organization
Contact information
Practice address
711 W 38TH ST, STE G1A, AUSTIN, TX 78705-1121
(512) 452-3100
(512) 452-3200
Mailing address
711 W 38TH ST, STE G1A, AUSTIN, TX 78705-1121
(512) 452-3100
(512) 452-3200
Taxonomy
Speciality
Code
Description
License number
State
156FX1700X
Ocularist
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
195117001
—
TX
01
—
532747
BLUECROSS BLUESHIELD OF TEXAS
TX
Enumeration date
09/25/2007
Last updated
05/26/2011
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