MEDICARE: FREDERICKSBURG EYE ASSOCIATES, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician

General Provider Information

NPI Number	:	1023515533
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FREDERICKSBURG EYE ASSOCIATES, PLLC

Provider Business Mailing Address
First Line	:	751 S WASHINGTON ST
Second Line	:
City	:	FREDERICKSBURG
State	:	TX
Zip	:	78624-5022
Country	:	US
Telephone Number	:	830-997-6535
Fax Number	:	830-997-9695

Provider Business Practice Location Address
First Line	:	751 S WASHINGTON ST
Second Line	:
City	:	FREDERICKSBURG
State	:	TX
Zip	:	78624-5022
Country	:	US
Telephone Number	:	830-997-6535
Fax Number	:	830-997-9695

Authorized Official
Title or Position	:	OWNER
Name	:	ANNE C. PLUENNEKE
Credential	:	M.D.
Telephone Number	:	830-997-6535

Provider Enumeration Date	:	04/11/2018
Last Update Date	:	01/24/2026

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