Provider Demographics
NPI:1275231938
Name:HOWERTON EYE CLINIC PLLC
Entity Type:Organization
Organization Name:HOWERTON EYE CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-443-9715
Mailing Address - Street 1:2610 S IH 35
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-5703
Mailing Address - Country:US
Mailing Address - Phone:512-443-9715
Mailing Address - Fax:512-443-9845
Practice Address - Street 1:4282 S FM 1626 STE 200
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-3288
Practice Address - Country:US
Practice Address - Phone:512-443-9715
Practice Address - Fax:512-443-9845
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOWERTON EYE CLINIC PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-02-21
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX200101801Medicaid
TX1811133507OtherNPI 2