| |
12221 Mo Pac Expwy North, Dept Of Ophthalmology, Austin, TX 78758 | |
(512) 901-4014 | |
(512) 901-3914 |
Full Name | |
---|---|
Type | Facility |
Speciality | Ophthalmology |
Location | 12221 Mo Pac Expwy North, Austin, Texas |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1568436764 | NPI | - | NPPES |
140347910 | Medicaid | TX | |
140347956 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
207W00000X | Ophthalmology | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
2000 Health Park Dr Dept Of, Brentwood, TN 37027-4525 Ph: (615) 372-5004 | 12221 Mo Pac Expwy North, Dept Of Ophthalmology, Austin, TX 78758 Ph: (512) 901-4014 |