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General NPI Number Information
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NPI Number | 1679737027
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Entity Type | Organization
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Legal Business Name | STARS IN YOUR EYES OPTOMETRY
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Dates
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Enumeration Date | 07/15/2008
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Last Update Date | 07/15/2008
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Provider Practice Location Address
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Address Line | 714 CONGRESS AVE STE 100
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City | AUSTIN
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State | TX
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Zip | 78701-3428
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Country | US
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Telephone | 512-477-9000
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Fax | 512-477-9105
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Provider Business Mailing Address
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Address Line | 714 CONGRESS AVE STE 100
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City | AUSTIN
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State | TX
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Zip | 78701-3428
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Country | US
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Telephone | 512-477-9000
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Fax | 512-477-9105
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Authorized Official
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Title or Position | OWNER / OPTOMETRIST
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Name | EMILY H. SCHOTTMAN
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Credential | OD
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Telephone | 512-477-9000
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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 | 5531T
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License Number State | TX
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