| NPI | 1285797621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON F DIETLEIN President 512-931-2255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX H0298) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 04076T) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2009-04-17 |