Provider Demographics
NPI:1356103758
Name:WESTLAKE EYE OBS LLC
Entity type:Organization
Organization Name:WESTLAKE EYE OBS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ZARMEENA
Authorized Official - Middle Name:
Authorized Official - Last Name:VENDAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-472-4011
Mailing Address - Street 1:5200 DAVIS LN STE 120
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749-4064
Mailing Address - Country:US
Mailing Address - Phone:512-472-4011
Mailing Address - Fax:
Practice Address - Street 1:5200 DAVIS LN STE 120
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78749-4064
Practice Address - Country:US
Practice Address - Phone:512-472-4011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-30
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery