Provider Demographics
NPI:1003297417
Name:LECHLITNER, STEPHANIE LYNN (OD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:LYNN
Last Name:LECHLITNER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 NUECES ST
Mailing Address - Street 2:SUITE 70
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-4195
Mailing Address - Country:US
Mailing Address - Phone:512-643-2020
Mailing Address - Fax:
Practice Address - Street 1:360 NUECES ST
Practice Address - Street 2:SUITE 70
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-4195
Practice Address - Country:US
Practice Address - Phone:512-643-2020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-11
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8688TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8688TGOtherTEXAS STATE LICENSE NUMBER