Healthcare Provider Details

I. General information

NPI: 1700651957
Provider Name (Legal Business Name): EYE SURGERY OF AUSTIN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2023
Last Update Date: 12/29/2023
Certification Date: 12/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3410 FAR WEST BLVD STE 140
AUSTIN TX
78731-3167
US

IV. Provider business mailing address

3410 FAR WEST BLVD STE 140
AUSTIN TX
78731-3167
US

V. Phone/Fax

Practice location:
  • Phone: 512-427-1100
  • Fax:
Mailing address:
  • Phone: 512-427-1100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: FARHAD IRSHAD
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 512-427-1100