Provider Demographics
NPI:1518235779
Name:TJF OPTOMETRIC HOLDINGS P.L.L.C
Entity Type:Organization
Organization Name:TJF OPTOMETRIC HOLDINGS P.L.L.C
Other - Org Name:EYES OF TEXAS VISION CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER /MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:FERN
Authorized Official - Middle Name:
Authorized Official - Last Name:YEE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:512-454-5117
Mailing Address - Street 1:8001 BURNET RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-8122
Mailing Address - Country:US
Mailing Address - Phone:512-454-5117
Mailing Address - Fax:512-450-1496
Practice Address - Street 1:8001 BURNET RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757-8122
Practice Address - Country:US
Practice Address - Phone:512-454-5117
Practice Address - Fax:512-450-1496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-02
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7902152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8B4554OtherMEDICARE
TX8B4554OtherMEDICARE