Provider Demographics
NPI:1619566494
Name:BLUEBONNET VISION ASSOCIATES
Entity Type:Organization
Organization Name:BLUEBONNET VISION ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMATHA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:TOMEFF
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:512-808-0872
Mailing Address - Street 1:4859 WILLIAMS DR STE 103
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78633-2304
Mailing Address - Country:US
Mailing Address - Phone:512-808-0872
Mailing Address - Fax:512-808-0669
Practice Address - Street 1:4859 WILLIAMS DR STE 103
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78633-2304
Practice Address - Country:US
Practice Address - Phone:512-808-0872
Practice Address - Fax:512-808-0669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-15
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty