Healthcare Provider Details

I. General information

NPI: 1164179164
Provider Name (Legal Business Name): TEXAN EYE, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2022
Last Update Date: 03/17/2022
Certification Date: 03/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2430 S IH 35
SAN MARCOS TX
78666-5906
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: 512-327-7000
  • Fax: 512-314-1662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0009X
TaxonomyGlaucoma Specialist (Ophthalmology) Physician
License Number
License Number State

VIII. Authorized Official

Name: SHELI MARIE CRABTREE
Title or Position: ADMINISTRATIVE SERVICES MANAGER
Credential:
Phone: 512-314-1613