| NPI | 1568032522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELI MARIE CRABTREE Senior Credentialing Manager 512-314-1613 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2021-06-30 |
| Last Update Date | 2024-01-03 |