Organization
ELITE EYE SPECIALISTS
Active
Parent organization
PROVISTA EYE CLINIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVISTA EYE CLINIC
Authorized official
DR. LINDA VARGAS MD (MD OWNER)
(512) 282-3937
Entity
Organization
Contact information
Practice address
11215 S IH 35, SUITE 102, AUSTIN, TX 78747-1863
(512) 282-3937
Mailing address
11215 S IH 35, SUITE 102, AUSTIN, TX 78747-1863
(512) 282-3937
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
62667G
TX
207W00000X
Ophthalmology Physician
Primary
L4779
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3376983
AETNA
TX
Enumeration date
10/10/2006
Last updated
04/02/2008
Update your record
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