Provider Demographics
NPI:1497751838
Name:EYE INSTITUTE OF AUSTIN
Entity Type:Organization
Organization Name:EYE INSTITUTE OF AUSTIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-454-8744
Mailing Address - Street 1:3300 W ANDERSON LN
Mailing Address - Street 2:STE 308
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-1023
Mailing Address - Country:US
Mailing Address - Phone:512-454-8744
Mailing Address - Fax:512-279-2990
Practice Address - Street 1:3300 W ANDERSON LN
Practice Address - Street 2:STE 308
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757-1023
Practice Address - Country:US
Practice Address - Phone:512-454-8744
Practice Address - Fax:512-279-2990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-21
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX093815101Medicaid
TX0263580003Medicare NSC
TX093815101Medicaid
TX0263580003Medicare PIN