Provider Demographics
NPI:1619179108
Name:AUSTIN VISION CENTER
Entity Type:Organization
Organization Name:AUSTIN VISION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUTSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-477-2282
Mailing Address - Street 1:2415 EXPOSITION BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78703-2268
Mailing Address - Country:US
Mailing Address - Phone:512-477-2282
Mailing Address - Fax:512-477-2336
Practice Address - Street 1:2415 EXPOSITION BLVD STE D
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78703-2268
Practice Address - Country:US
Practice Address - Phone:512-477-2282
Practice Address - Fax:512-477-2336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00E80PMedicare ID - Type Unspecified
TXU27357Medicare UPIN