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3705 Medical Pkwy Ste 460, Austin, TX 78705-1024 | |
(512) 454-5851 | |
(512) 454-5853 |
Full Name | |
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Type | Facility |
Speciality | Ophthalmology |
Location | 3705 Medical Pkwy Ste 460, Austin, Texas |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1346310646 | NPI | - | NPPES |
2194029-01 | Medicaid | TX | |
2857203-01 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (Texas) | Secondary |
207W00000X | Ophthalmology | (Texas) | Primary |
Provider Name | Chirag Dilip Jhaveri |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1114117769 PECOS PAC ID: 1456548296 Enrollment ID: I20120727000415 |
Provider Name | Saradha Chexal |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1013258730 PECOS PAC ID: 3971741869 Enrollment ID: I20140910000939 |
Provider Name | Gowtham Jonna |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1245529767 PECOS PAC ID: 9537471032 Enrollment ID: I20170712000273 |
Mailing Address | Practice Location Address |
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3705 Medical Pkwy Ste 460, Austin, TX 78705-1024 Ph: (512) 454-5851 | 3705 Medical Pkwy Ste 460, Austin, TX 78705-1024 Ph: (512) 454-5851 |