Provider Demographics
NPI:1942286448
Name:TAUCH, DAVID RUSSELL (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:RUSSELL
Last Name:TAUCH
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5717 BALCONES DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4203
Mailing Address - Country:US
Mailing Address - Phone:512-327-7000
Mailing Address - Fax:512-314-1662
Practice Address - Street 1:85 LOOP 150 W
Practice Address - Street 2:
Practice Address - City:BASTROP
Practice Address - State:TX
Practice Address - Zip Code:78602
Practice Address - Country:US
Practice Address - Phone:512-303-7300
Practice Address - Fax:512-303-2148
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1830152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX919025OtherBLOCK VISION
SC410048006Medicare PIN
TX10013125OtherAMERIGROUP
TX8503B6Medicare PIN
TX112399404Medicaid
TX4367379OtherAETNA
TX8116218OtherBLUELINK
TX1830OtherEYEMED
146574100OtherFIRST CARE
VP15083OtherGE WELLNESS
TX80702QOtherBLUE CROSS BLUE SHIELD
T16218Medicare UPIN