Healthcare Provider Details
I. General information
NPI: 1295135267
Provider Name (Legal Business Name): LOOK SEE VISION CARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/27/2014
Last Update Date: 05/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2007 S 1ST ST SUITE 104
AUSTIN TX
78704-5141
US
IV. Provider business mailing address
2007 S 1ST ST SUITE 104
AUSTIN TX
78704-5141
US
V. Phone/Fax
- Phone: 512-774-6002
- Fax: 512-774-5975
- Phone: 512-774-6002
- Fax: 512-774-5975
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | 8425-TG |
| License Number State | TX |
VIII. Authorized Official
Name:
TAMMY
M.
VO
Title or Position: OD/OWNER
Credential: OD/OWNER
Phone: 281-743-1129