Provider Demographics
NPI:1043211535
Name:HOBUSS, MICHAEL P (OD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:P
Last Name:HOBUSS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15300-B FM 1825
Mailing Address - Street 2:STE 111
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-8066
Mailing Address - Country:US
Mailing Address - Phone:512-670-2600
Mailing Address - Fax:512-670-2667
Practice Address - Street 1:15300-B FM 1825
Practice Address - Street 2:STE 111
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-8066
Practice Address - Country:US
Practice Address - Phone:512-670-2600
Practice Address - Fax:512-670-2667
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX2572T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1174717854OtherCORPORATE NPI
TX742570188OtherCORP TAX ID
TXTX2572OtherVISION INSURER ID
TXTX2572OtherVISION INSURER ID
TX1174717854OtherCORPORATE NPI
TXT13857Medicare UPIN