Provider Demographics
NPI:1285187377
Name:MCCORMICK VISION PC
Entity Type:Organization
Organization Name:MCCORMICK VISION PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE BILLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-258-9233
Mailing Address - Street 1:12701 RESEARCH BLVD
Mailing Address - Street 2:STE 101
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-4386
Mailing Address - Country:US
Mailing Address - Phone:512-258-2020
Mailing Address - Fax:512-258-7835
Practice Address - Street 1:12701 RESEARCH BLVD
Practice Address - Street 2:STE 101
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-4386
Practice Address - Country:US
Practice Address - Phone:512-258-2020
Practice Address - Fax:512-258-7835
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-26
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty