MEDICARE: LIBERTY HILL EYE ASSOCIATES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396732731
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIBERTY HILL EYE ASSOCIATES, LLC

Provider Business Mailing Address
First Line	:	14370 W. HWY. 29
Second Line	:	SUITE 8
City	:	LIBERTY HILL
State	:	TX
Zip	:	78642
Country	:	US
Telephone Number	:	512-515-5100
Fax Number	:	512-515-0500

Provider Business Practice Location Address
First Line	:	14370 W. HWY. 29
Second Line	:	SUITE 8
City	:	LIBERTY HILL
State	:	TX
Zip	:	78642
Country	:	US
Telephone Number	:	512-515-5100
Fax Number	:	512-515-0500

Authorized Official
Title or Position	:	OWNER/THERAPEUTIC OPTOMETRIST
Name	:	DR. JAMES R. HANNIGAN
Credential	:	O.D.
Telephone Number	:	512-515-5100

Provider Enumeration Date	:	09/30/2005
Last Update Date	:	08/13/2008

Similar Medicare Providers

1891782223 — DR. JAMES R. HANNIGAN O.D.
Practice Location Address:

14370 W. HWY. 29 , SUITE 8
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78642

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1801863311 — MERIDELL ACHIEVEMENT CENTER
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1801847710 — DR. THAD HAROLD GILLESPIE D.D.S.
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1407800782 — DR. KAM M LEUNG D.C.
Practice Location Address:

12779 W STATE HIGHWAY 29 STE 100
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1669412110 — DR. WALTER DOUGLAS SCOTT D.C.
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1437193778 — LEIA MORRIS MORRIS DPT
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Directions to “LIBERTY HILL EYE ASSOCIATES, LLC ” Practice Location

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