MEDICARE: LASIKPLUS OF TEXAS, P.A.

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	261QS0132X	Ophthalmologic Surgery Clinic/Center

General Provider Information

NPI Number	:	1669527412
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LASIKPLUS OF TEXAS, P.A.

Provider Business Mailing Address
First Line	:	7840 MONTGOMERY RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45236-4301
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9705 RESEARCH BLVD
Second Line	:	ARBORETUM SHOPPING CENTER
City	:	AUSTIN
State	:	TX
Zip	:	78759-5821
Country	:	US
Telephone Number	:	512-382-3850
Fax Number	:

Authorized Official
Title or Position	:	V.P. MANAGED CARE
Name	:	SCOTT KIRK
Credential	:
Telephone Number	:	800-688-4550

Provider Enumeration Date	:	01/24/2007
Last Update Date	:	08/22/2020

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