Healthcare Provider Details

I. General information

NPI: 1598957334
Provider Name (Legal Business Name): HANSA ANONETAPIPAT HUANG O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2007
Last Update Date: 04/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10900 LAKELINE MALL DR
AUSTIN TX
78717-5924
US

IV. Provider business mailing address

13512 HYMEADOW CIR
AUSTIN TX
78729-1763
US

V. Phone/Fax

Practice location:
  • Phone: 512-257-0279
  • Fax: 512-651-3381
Mailing address:
  • Phone: 512-257-0279
  • Fax: 512-651-3381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number7134TG
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: