Healthcare Provider Details

I. General information

NPI: 1699347211
Provider Name (Legal Business Name): ANNIE AVILEZ OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNIE SYKES

II. Dates (important events)

Enumeration Date: 07/13/2021
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3474 CATCLAW DR STE B
ABILENE TX
79606-8234
US

IV. Provider business mailing address

3474 CATCLAW DR STE B
ABILENE TX
79606-8234
US

V. Phone/Fax

Practice location:
  • Phone: 325-455-1157
  • Fax:
Mailing address:
  • Phone:
  • Fax: 325-399-9100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number11542
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2832
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: