Provider Demographics
NPI:1356084222
Name:AUSTIN, THOMAS E (OD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:E
Last Name:AUSTIN
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3341 8TH ST S
Mailing Address - Street 2:
Mailing Address - City:WISCONSIN RAPIDS
Mailing Address - State:WI
Mailing Address - Zip Code:54494-6566
Mailing Address - Country:US
Mailing Address - Phone:715-423-5353
Mailing Address - Fax:715-423-6525
Practice Address - Street 1:3341 8TH ST S
Practice Address - Street 2:
Practice Address - City:WISCONSIN RAPIDS
Practice Address - State:WI
Practice Address - Zip Code:54494-6566
Practice Address - Country:US
Practice Address - Phone:715-423-5353
Practice Address - Fax:715-423-6525
Is Sole Proprietor?:No
Enumeration Date:2022-04-18
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046011712152W00000X
WI403235152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist