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General NPI Number Information
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NPI Number | 1619262417
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Entity Type | Organization
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Legal Business Name | STARS IN YOUR EYES VISION TRAINING CENTER LLC
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Dates
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Enumeration Date | 06/09/2011
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Last Update Date | 06/09/2011
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Provider Practice Location Address
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Address Line | 3305 NORTHLAND DR STE 312
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City | AUSTIN
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State | TX
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Zip | 78731-4961
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Country | US
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Telephone | 512-419-1212
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Fax |
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Provider Business Mailing Address
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Address Line | 3305 NORTHLAND DR STE 312
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City | AUSTIN
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State | TX
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Zip | 78731-4961
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Country | US
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Telephone | 512-419-1212
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | EMILY SCHOTTMAN
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Credential | O.D.
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Telephone | 512-419-1212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WP0200X
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Taxonomy Name | Pediatric Optometrist
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License Number | 5531T
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 152WS0006X
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Taxonomy Name | Sports Vision Optometrist
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License Number | 5531T
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 152WV0400X
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Taxonomy Name | Vision Therapy Optometrist
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License Number | 5531T
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License Number State | TN
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