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General NPI Number Information
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NPI Number | 1619289873
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Entity Type | Individual
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Provider Name | JAMES CASEY PACKER O.D.
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Gender | Male
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Dates
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Enumeration Date | 07/05/2010
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Last Update Date | 04/02/2012
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Provider Practice Location Address
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Address Line | 2700 BARTON CREEK BLVD STE 110
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City | AUSTIN
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State | TX
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Zip | 78730-1528
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Country | US
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Telephone | 512-328-7300
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Fax |
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Provider Business Mailing Address
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Address Line | 2700 BARTON CREEK BLVD STE 110
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City | AUSTIN
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State | TX
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Zip | 78735-1637
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Country | US
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Telephone | 512-328-7300
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 7577T
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License Number State | TX
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