Provider Demographics
NPI:1114977709
Name:MAYBURY, RICHARD HOBSON (OD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:HOBSON
Last Name:MAYBURY
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 1:1201 BARBARA JORDAN BLVD
Mailing Address - Street 2:SUITE 1480
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-3083
Mailing Address - Country:US
Mailing Address - Phone:512-452-3227
Mailing Address - Fax:512-371-1418
Practice Address - Street 1:1201 BARBARA JORDAN BLVD
Practice Address - Street 2:SUITE 1480
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-3083
Practice Address - Country:US
Practice Address - Phone:512-452-3227
Practice Address - Fax:512-371-1418
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2278152WC0802X
TX5424TG152WC0802X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX81982QOtherBC/BS
TX81982QOtherBC/BS