Provider Demographics
NPI:1679737027
Name:STARS IN YOUR EYES OPTOMETRY
Entity Type:Organization
Organization Name:STARS IN YOUR EYES OPTOMETRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:H
Authorized Official - Last Name:SCHOTTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:512-477-9000
Mailing Address - Street 1:714 CONGRESS AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-3428
Mailing Address - Country:US
Mailing Address - Phone:512-477-9000
Mailing Address - Fax:512-477-9105
Practice Address - Street 1:714 CONGRESS AVE STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-3428
Practice Address - Country:US
Practice Address - Phone:512-477-9000
Practice Address - Fax:512-477-9105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-15
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5531T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX81309QOtherBCBS