Provider Demographics
NPI:1770638181
Name:SIGNATURE EYE CARE, P.A.
Entity Type:Organization
Organization Name:SIGNATURE EYE CARE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:OLIVER
Authorized Official - Middle Name:KUANG-YEN
Authorized Official - Last Name:LOU
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:512-250-1700
Mailing Address - Street 1:2051 CYPRESS CREEK RD
Mailing Address - Street 2:STE M
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-3623
Mailing Address - Country:US
Mailing Address - Phone:512-250-1700
Mailing Address - Fax:512-250-1769
Practice Address - Street 1:2051 CYPRESS CREEK RD
Practice Address - Street 2:STE M
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-3623
Practice Address - Country:US
Practice Address - Phone:512-250-1700
Practice Address - Fax:512-250-1769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6085TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX80750QOtherBLUE CROSS BLUE SHIELD TX
TXU86514Medicare UPIN
TX80750QOtherBLUE CROSS BLUE SHIELD TX