Provider Demographics
NPI:1043462229
Name:EACTX
Entity Type:Organization
Organization Name:EACTX
Other - Org Name:EYE ASSOCIATES OF CENTRAL TEXAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:TRINCA
Authorized Official - Last Name:GOLDE
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:512-244-1991
Mailing Address - Street 1:2120 ROUND ROCK AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-4010
Mailing Address - Country:US
Mailing Address - Phone:512-244-1991
Mailing Address - Fax:512-244-1786
Practice Address - Street 1:2120 ROUND ROCK AVE STE 100
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-4010
Practice Address - Country:US
Practice Address - Phone:512-244-1991
Practice Address - Fax:512-244-1786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0A0260Medicare PIN
TX6203840001Medicare NSC