Provider Demographics
NPI:1679062798
Name:ABBADONDO ENTERPRISES PLLC
Entity Type:Organization
Organization Name:ABBADONDO ENTERPRISES PLLC
Other - Org Name:WESTLAKE HILLS VISION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ELIZONDO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:210-288-6716
Mailing Address - Street 1:3801 N CAPITAL OF TEXAS HWY STE C100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-1466
Mailing Address - Country:US
Mailing Address - Phone:210-288-6716
Mailing Address - Fax:
Practice Address - Street 1:3801 N CAPITAL OF TEXAS HWY STE C100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-1466
Practice Address - Country:US
Practice Address - Phone:512-651-5186
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-03
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7669TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1073814216OtherNPPES