MEDICARE: STARS IN YOUR EYES OPTOMETRY

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	5531T	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	81309Q	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1396900221
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STARS IN YOUR EYES OPTOMETRY

Provider Business Mailing Address
First Line	:	2116 HANCOCK DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78756-2507
Country	:	US
Telephone Number	:	512-371-0144
Fax Number	:	512-371-0164

Provider Business Practice Location Address
First Line	:	2116 HANCOCK DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78756-2507
Country	:	US
Telephone Number	:	512-371-0144
Fax Number	:	512-371-0164

Authorized Official
Title or Position	:	OWNER / OPTOMETRIST
Name	:	DR. EMILY H. SCHOTTMAN
Credential	:	OD
Telephone Number	:	512-371-0144

Provider Enumeration Date	:	07/21/2008
Last Update Date	:	10/08/2010

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Directions to “STARS IN YOUR EYES OPTOMETRY ” Practice Location

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