Provider Demographics
NPI:1568956753
Name:OUSLEY, AUDRIE KRAEMER (OD)
Entity Type:Individual
Prefix:DR
First Name:AUDRIE
Middle Name:KRAEMER
Last Name:OUSLEY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2430 JUSTIN RD STE A
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-3090
Mailing Address - Country:US
Mailing Address - Phone:972-317-3937
Mailing Address - Fax:
Practice Address - Street 1:2430 JUSTIN RD STE A
Practice Address - Street 2:
Practice Address - City:HIGHLAND VILLAGE
Practice Address - State:TX
Practice Address - Zip Code:75077-3090
Practice Address - Country:US
Practice Address - Phone:972-317-3937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-20
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9451T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist