Individual
TANYA KOHLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
13343 N US HIGHWAY 183 STE 215, AUSTIN, TX 78750-7167
(972) 795-4579
Mailing address
4711 E RIVERSIDE DR APT 2428, AUSTIN, TX 78741-5045
(972) 795-4579
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
9779T
TX
152WS0006X
Sports Vision Optometrist
9779T
TX
152WV0400X
Vision Therapy Optometrist
Primary
9779T
TX
Other
Enumeration date
08/19/2020
Last updated
07/23/2021
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