Provider Demographics
NPI:1073136685
Name:TEXAN EYE, P.A.
Entity Type:Organization
Organization Name:TEXAN EYE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL STAFF SERVICES COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHELI
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CRABTREE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:512-314-1613
Mailing Address - Street 1:5717 BALCONES DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4203
Mailing Address - Country:US
Mailing Address - Phone:512-314-1613
Mailing Address - Fax:512-314-1661
Practice Address - Street 1:501 E PALM VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-3000
Practice Address - Country:US
Practice Address - Phone:512-327-7000
Practice Address - Fax:512-314-1662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-19
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0857443-01Medicaid