Provider Demographics
NPI:1255328951
Name:DAVID R. STARNES, OD, INC.
Entity type:Organization
Organization Name:DAVID R. STARNES, OD, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/THERAPEUTIC OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:R
Authorized Official - Last Name:STARNES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:512-443-4317
Mailing Address - Street 1:4409 MANCHACA RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-1603
Mailing Address - Country:US
Mailing Address - Phone:512-443-4317
Mailing Address - Fax:512-443-0882
Practice Address - Street 1:4409 MANCHACA RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1603
Practice Address - Country:US
Practice Address - Phone:512-443-4317
Practice Address - Fax:512-443-0882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-29
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision RehabilitationGroup - Single Specialty
No152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0379190001Medicare NSC
TX00429VMedicare ID - Type Unspecified