Organization
AUSTIN EYE CLINIC ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON WONG MD (OWNER)
(512) 250-2020
Entity
Organization
Contact information
Practice address
2700 BEE CAVES RD, AUSTIN, TX 78746-5675
(512) 250-2020
(512) 250-2612
Mailing address
11901 JOLLYVILLE RD, AUSTIN, TX 78759-2303
(512) 250-2020
(512) 250-2612
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00K61V
BCBS
TX
05
—
083533201
—
TX
Enumeration date
10/17/2007
Last updated
09/08/2020
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