Provider Demographics
NPI:1689845869
Name:ACADEMY OF LASER VISION SCIENCES, LLC
Entity Type:Organization
Organization Name:ACADEMY OF LASER VISION SCIENCES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:C
Authorized Official - Last Name:THORNE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-349-2015
Mailing Address - Street 1:901 S. MOPAC EXPRESSWAY
Mailing Address - Street 2:BLDG 4 SUITE 350
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746
Mailing Address - Country:US
Mailing Address - Phone:512-349-2015
Mailing Address - Fax:512-347-0785
Practice Address - Street 1:901 S. MOPAC EXPRESSWAY
Practice Address - Street 2:BUILDING 4, SUITE 350
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746
Practice Address - Country:US
Practice Address - Phone:512-349-2015
Practice Address - Fax:512-347-0785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-17
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery