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General NPI Number Information
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NPI Number | 1497842439
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Entity Type | Organization
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Legal Business Name | ELITE EYE SPECIALISTS
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 04/02/2008
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Provider Practice Location Address
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Address Line | 11215 S IH 35 SUITE 102
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City | AUSTIN
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State | TX
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Zip | 78747-1863
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Country | US
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Telephone | 512-282-3937
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Fax |
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Provider Business Mailing Address
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Address Line | 11215 S IH 35 SUITE 102
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City | AUSTIN
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State | TX
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Zip | 78747-1863
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Country | US
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Telephone | 512-282-3937
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Fax |
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Authorized Official
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Title or Position | MD OWNER
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Name | DR. LINDA VARGAS
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Credential | MD
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Telephone | 512-282-3937
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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 | 62667G
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | L4779
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License Number State | TX
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