Healthcare Provider Details

I. General information

NPI: 1033205414
Provider Name (Legal Business Name): BARBARA ALLEN COLDIRON O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 09/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3908 FAR WEST BLVD
AUSTIN TX
78731-2994
US

IV. Provider business mailing address

6509 MARBLEWOOD DRIVE
AUSTIN TX
78731
US

V. Phone/Fax

Practice location:
  • Phone: 512-343-0432
  • Fax: 512-583-0588
Mailing address:
  • Phone: 512-673-6965
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2827TG
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number2827TG
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number2827TG
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number2827TG
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code152WS0006X
TaxonomySports Vision Optometrist
License Number2827TG
License Number StateTX
# 6
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number2827TG
License Number StateTX
# 7
Primary TaxonomyN
Taxonomy Code152WX0102X
TaxonomyOccupational Vision Optometrist
License Number2827TG
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: