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General NPI Number Information
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NPI Number | 1043800717
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Entity Type | Organization
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Legal Business Name | BC EYEFITTERS PLLC
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Dates
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Enumeration Date | 01/26/2021
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Last Update Date | 07/13/2021
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Provider Practice Location Address
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Address Line | 4900 BEE CREEK RD STE 102
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City | SPICEWOOD
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State | TX
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Zip | 78669-6776
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Country | US
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Telephone | 512-744-6274
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Fax | 512-744-6319
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Provider Business Mailing Address
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Address Line | 424 MALABAR ST
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City | LAKEWAY
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State | TX
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Zip | 78734-5065
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Country | US
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Telephone | 512-744-6274
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Fax | 512-744-6319
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Authorized Official
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Title or Position | OWNER/OPTOMETRIST
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Name | DR. ROXANA RODRIGUEZ LEIJA
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Credential | OD
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Telephone | 512-744-6274
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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