Provider Demographics
NPI:1043372501
Name:BEE CAVE VISION CENTER P A
Entity Type:Organization
Organization Name:BEE CAVE VISION CENTER P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:DOBSON
Authorized Official - Suffix:
Authorized Official - Credentials:O D
Authorized Official - Phone:512-804-2020
Mailing Address - Street 1:12400 W HIGHWAY 71 STE 310
Mailing Address - Street 2:
Mailing Address - City:BEE CAVE
Mailing Address - State:TX
Mailing Address - Zip Code:78738-6504
Mailing Address - Country:US
Mailing Address - Phone:512-804-2020
Mailing Address - Fax:
Practice Address - Street 1:12400 W HIGHWAY 71 STE 310
Practice Address - Street 2:
Practice Address - City:BEE CAVE
Practice Address - State:TX
Practice Address - Zip Code:78738-6504
Practice Address - Country:US
Practice Address - Phone:512-804-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00X157Medicare PIN