Healthcare Provider Details

I. General information

NPI: 1871872911
Provider Name (Legal Business Name): NICOLE DAWN ESLER O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2011
Last Update Date: 01/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 RED BUD LN
ROUND ROCK TX
78664-3802
US

IV. Provider business mailing address

1701 RED BUD LN
ROUND ROCK TX
78664-3802
US

V. Phone/Fax

Practice location:
  • Phone: 512-341-2020
  • Fax:
Mailing address:
  • Phone: 512-341-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number7800TG
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: