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General NPI Number Information
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NPI Number | 1366748352
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Entity Type | Organization
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Legal Business Name | GREGG E KAMNETZ O.D., P.C.
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Dates
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Enumeration Date | 02/08/2011
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Last Update Date | 06/12/2012
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Provider Practice Location Address
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Address Line | 2712 BEE CAVE RD SUITE 118
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City | AUSTIN
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State | TX
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Zip | 78746-5676
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Country | US
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Telephone | 512-327-3605
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Fax | 512-327-3803
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Provider Business Mailing Address
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Address Line | 2712 BEE CAVE RD SUITE 118
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City | AUSTIN
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State | TX
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Zip | 78746-5676
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Country | US
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Telephone | 512-327-3605
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Fax | 512-327-3803
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GREGG EDWARD KAMNETZ
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Credential | OD
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Telephone | 512-327-3605
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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 | 3486TG
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License Number State | TX
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