=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508793290
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HILLCREST OPHTHALMOLOGY, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/06/2026
-----------------------------------------------------
Last Update Date | 05/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14370 W STATE HIGHWAY 29 STE 8
-----------------------------------------------------
City | LIBERTY HILL
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78642-5796
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 435-660-9774
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 605 W SOUTH ST UNIT 352
-----------------------------------------------------
City | LEANDER
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78641-5403
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 435-660-9774
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PROVIDER
-----------------------------------------------------
Name | KARL ANDERSEN
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 435-660-9774
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QS0132X
-----------------------------------------------------
Taxonomy Name | Ophthalmologic Surgery Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------