Provider Demographics
NPI:1639752074
Name:FOCUS OPTOMETRY GROUP, PLLC
Entity Type:Organization
Organization Name:FOCUS OPTOMETRY GROUP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:WILLIAMS
Authorized Official - Last Name:HASELHORST
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:210-454-9852
Mailing Address - Street 1:7709 MENCHACA RD UNIT 29
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-6026
Mailing Address - Country:US
Mailing Address - Phone:210-454-9852
Mailing Address - Fax:512-253-7928
Practice Address - Street 1:7709 MENCHACA RD UNIT 29
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-6026
Practice Address - Country:US
Practice Address - Phone:210-454-9852
Practice Address - Fax:512-253-7928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-03
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX217339505Medicaid
TX291719702Medicaid