Provider Demographics
NPI:1588217509
Name:LIVE OAK VISION, PLLC
Entity Type:Organization
Organization Name:LIVE OAK VISION, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:SUMMERS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:361-920-3983
Mailing Address - Street 1:7609 KIVA DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749-2915
Mailing Address - Country:US
Mailing Address - Phone:361-920-3983
Mailing Address - Fax:
Practice Address - Street 1:7225 W HIGHWAY 71 STE B
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735-8351
Practice Address - Country:US
Practice Address - Phone:512-892-1864
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-18
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty