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General NPI Number Information
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NPI Number | 1891216438
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Entity Type | Organization
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Legal Business Name | BELTERRA EYECARE PLLC
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Dates
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Enumeration Date | 07/05/2017
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Last Update Date | 10/08/2020
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Provider Practice Location Address
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Address Line | 165 HARGRAVES DRIVE SUITE M600
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City | AUSTIN
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State | TX
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Zip | 78737-7873
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Country | US
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Telephone | 785-331-6939
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Fax | 785-331-6939
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Provider Business Mailing Address
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Address Line | 165 HARGRAVES DR STE M600
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City | AUSTIN
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State | TX
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Zip | 78737-4815
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Country | US
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Telephone | 512-301-8664
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ROBERT RAMP
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Credential | OD
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Telephone | 512-301-8664
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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 | 7770T
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License Number State | TX
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