Individual
DR. DARCY LYNN GROSTICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
4600 MUELLER BLVD, APT #4029, AUSTIN, TX 78723-3186
(312) 593-4361
Mailing address
4600 MUELLER BLVD, APT #4029, AUSTIN, TX 78723-3186
(312) 593-4361
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
046009870
IL
152W00000X
Optometrist
Primary
8526T
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046009870
—
IL
01
—
1636706
BCBS
IL
01
—
210209
MEDICARE GROUP
IL
01
—
211019
MEDICARE GROUP
IL
01
—
362492289
TAX ID
IL
01
—
7235044
AETNA
IL
Enumeration date
07/28/2006
Last updated
01/28/2016
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