Provider Demographics
NPI:1942270103
Name:TEXAS OCULOPLASTIC CONSULTANTS LLP
Entity Type:Organization
Organization Name:TEXAS OCULOPLASTIC CONSULTANTS LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VIKRAM
Authorized Official - Middle Name:D
Authorized Official - Last Name:DURAIRAJ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-458-2141
Mailing Address - Street 1:3705 MEDICAL PKWY
Mailing Address - Street 2:SUITE 120
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1019
Mailing Address - Country:US
Mailing Address - Phone:512-458-2141
Mailing Address - Fax:512-458-4824
Practice Address - Street 1:3705 MEDICAL PKWY
Practice Address - Street 2:SUITE 120
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1019
Practice Address - Country:US
Practice Address - Phone:512-458-2141
Practice Address - Fax:512-458-4824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-23
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive SurgeryGroup - Single Specialty
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX180024852OtherRAILROAD MEDICARE
TX0086AZOtherBCBS
TX095049501Medicaid
TX095049501Medicaid