Provider Demographics
NPI:1164758819
Name:AUSTIN VITRECTOMY CHAIR RENTALS
Entity Type:Organization
Organization Name:AUSTIN VITRECTOMY CHAIR RENTALS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTEL
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:PITTSFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-547-1836
Mailing Address - Street 1:13432 HOLLY CREST TER
Mailing Address - Street 2:
Mailing Address - City:MANOR
Mailing Address - State:TX
Mailing Address - Zip Code:78653-3749
Mailing Address - Country:US
Mailing Address - Phone:512-547-1836
Mailing Address - Fax:
Practice Address - Street 1:13432 HOLLY CREST TER
Practice Address - Street 2:
Practice Address - City:MANOR
Practice Address - State:TX
Practice Address - Zip Code:78653-3749
Practice Address - Country:US
Practice Address - Phone:512-547-1836
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-29
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies