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General NPI Number Information
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NPI Number | 1881015311
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Entity Type | Organization
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Legal Business Name | AUGUSTIN EYE CARE PLC
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Dates
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Enumeration Date | 12/31/2013
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 2027 CROSSROADS BLVD
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City | WATERLOO
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State | IA
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Zip | 50702-4405
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Country | US
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Telephone | 319-505-2142
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Fax | 319-505-2145
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Provider Business Mailing Address
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Address Line | 2027 CROSSROADS BLVD
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City | WATERLOO
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State | IA
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Zip | 50702-4405
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Country | US
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Telephone | 319-505-2142
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Fax | 319-505-2145
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Authorized Official
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Title or Position | OWNER
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Name | THOMAS J. AUGUSTIN
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Credential |
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Telephone | 641-201-1711
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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 | 002521
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License Number State | IA
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