Provider Demographics
NPI:1033176680
Name:DAVID J HAMMOND OD PC
Entity Type:Organization
Organization Name:DAVID J HAMMOND OD PC
Other - Org Name:BALCONES EYECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:HAMMOND
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:512-336-2371
Mailing Address - Street 1:13376 RESEARCH BLVD
Mailing Address - Street 2:SUITE #124
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-3250
Mailing Address - Country:US
Mailing Address - Phone:512-336-2371
Mailing Address - Fax:512-336-2373
Practice Address - Street 1:13376 RESEARCH BLVD
Practice Address - Street 2:SUITE #124
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-3250
Practice Address - Country:US
Practice Address - Phone:512-336-2371
Practice Address - Fax:512-336-2373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-27
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00695XMedicare PIN
Y22413Medicare UPIN