| NPI | 1083806400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIM STUART DEFEO Office Manager 512-255-7987 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 6067T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 6389T) |
| Enumeration Date | 2007-08-10 |
| Last Update Date | 2007-08-10 |