| NPI | 1023019163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERI DEABLER Practice Administrator 512-583-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 332H00000X Eyewear Supplier |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2013-07-01 |