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General NPI Number Information
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NPI Number | 1558792564
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Entity Type | Organization
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Legal Business Name | EYERIS VISION PLLC
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Dates
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Enumeration Date | 12/02/2013
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Last Update Date | 10/17/2014
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Provider Practice Location Address
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Address Line | 3111 SOUTH LAMAR BLVD.
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City | AUSTIN
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State | TX
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Zip | 78704
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Country | US
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Telephone | 512-222-5636
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Fax |
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Provider Business Mailing Address
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Address Line | 3111 SOUTH LAMAR BLVD.
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City | AUSTIN
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State | TX
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Zip | 78704
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Country | US
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Telephone | 512-222-5636
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Fax |
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Authorized Official
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Title or Position | PRESIDENT & CEO/OPTOMETRIST
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Name | DR. BICH NHAT LE
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Credential | OD
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Telephone | 512-222-5636
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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 | 7374TG
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License Number State | TX
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