MEDICARE: LONGHORN EYE CARE 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		TX

General Provider Information

NPI Number	:	1427576685
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LONGHORN EYE CARE PLLC

Provider Business Mailing Address
First Line	:	21315 NORTH SH 130 #B
Second Line	:
City	:	PFLUGERVILLE
State	:	TX
Zip	:	78660-2678
Country	:	US
Telephone Number	:	512-763-0869
Fax Number	:	888-965-5316

Provider Business Practice Location Address
First Line	:	21315 NORTH SH 130 #B
Second Line	:
City	:	PFLUGERVILLE
State	:	TX
Zip	:	78660-2678
Country	:	US
Telephone Number	:	512-763-0869
Fax Number	:	888-965-5316

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	ADAM D HART
Credential	:	MD
Telephone Number	:	512-763-0869

Provider Enumeration Date	:	09/07/2017
Last Update Date	:	07/21/2022

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