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General NPI Number Information
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NPI Number | 1922142231
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Entity Type | Individual
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Provider Name | CARLA GAVILANES GASPARINI O.D.
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Gender | Female
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Dates
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Enumeration Date | 02/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 9300 S I H 35 BLDG B
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City | AUSTIN
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State | TX
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Zip | 78748-1733
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Country | US
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Telephone | 512-345-2595
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Fax |
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Provider Business Mailing Address
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Address Line | 12407 N MO PAC EXPY STE 100 PMB 296
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City | AUSTIN
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State | TX
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Zip | 78758-2429
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Country | US
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Telephone | 512-345-2595
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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 | 5858 TG
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License Number State | TX
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