Healthcare Provider Details

I. General information

NPI: 1548373830
Provider Name (Legal Business Name): EYE INSTITUTE OF AUSTIN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 06/14/2021
Certification Date: 06/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 W ANDERSON LN #308
AUSTIN TX
78757-1023
US

IV. Provider business mailing address

3300 W ANDERSON LN #308
AUSTIN TX
78757-1023
US

V. Phone/Fax

Practice location:
  • Phone: 512-454-8744
  • Fax:
Mailing address:
  • Phone: 512-454-8744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207WX0009X
TaxonomyGlaucoma Specialist (Ophthalmology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207WX0120X
TaxonomyCornea and External Diseases Specialist Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: SABRINA YORK
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 512-454-8744