Provider Demographics
NPI:1518687979
Name:KALEC, DENNIS JOSEPH (OD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:JOSEPH
Last Name:KALEC
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7901 METROPOLIS DR RM 2F-523
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78744-3111
Mailing Address - Country:US
Mailing Address - Phone:512-823-4051
Mailing Address - Fax:512-823-4155
Practice Address - Street 1:7901 METROPOLIS DR RM 2F-523
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78744-3111
Practice Address - Country:US
Practice Address - Phone:512-823-4051
Practice Address - Fax:512-823-4155
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TX10684TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program