Provider Demographics
NPI:1922864206
Name:RESOLUTION EYECARE TECH RIDGE, PLLC
Entity Type:Organization
Organization Name:RESOLUTION EYECARE TECH RIDGE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUSTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:832-647-1621
Mailing Address - Street 1:6929 AIRPORT BLVD STE 165
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78752-3616
Mailing Address - Country:US
Mailing Address - Phone:512-580-9035
Mailing Address - Fax:
Practice Address - Street 1:12901 N INTERSTATE HWY 35
Practice Address - Street 2:STE 1305A
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78753
Practice Address - Country:US
Practice Address - Phone:512-739-7550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty