Provider Demographics
NPI:1538689112
Name:DEESE, ASHLEY M (OD)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:M
Last Name:DEESE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:M
Other - Last Name:REECE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:2700 BEE CAVES RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5642
Mailing Address - Country:US
Mailing Address - Phone:512-250-2020
Mailing Address - Fax:
Practice Address - Street 1:2700 BEE CAVES RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-5642
Practice Address - Country:US
Practice Address - Phone:314-607-7005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-23
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34670152W00000X
MO2017019289152W00000X
TX10353TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist