Healthcare Provider Details

I. General information

NPI: 1073136685
Provider Name (Legal Business Name): TEXAN EYE, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2020
Last Update Date: 05/19/2020
Certification Date: 05/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 E PALM VALLEY BLVD
ROUND ROCK TX
78664-3000
US

IV. Provider business mailing address

5717 BALCONES DR
AUSTIN TX
78731-4203
US

V. Phone/Fax

Practice location:
  • Phone: 512-327-7000
  • Fax: 512-314-1662
Mailing address:
  • Phone: 512-314-1613
  • Fax: 512-314-1661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: SHELI MARIE CRABTREE
Title or Position: MEDICAL STAFF SERVICES COORDINATOR
Credential: DO
Phone: 512-314-1613