Provider Demographics
NPI:1477574150
Name:SCOTT HRUBY OD
Entity type:Organization
Organization Name:SCOTT HRUBY OD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:HRUBY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:512-452-4160
Mailing Address - Street 1:7801 N LAMAR BLVD
Mailing Address - Street 2:STE D-74
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78752-1016
Mailing Address - Country:US
Mailing Address - Phone:512-452-4160
Mailing Address - Fax:512-206-0808
Practice Address - Street 1:7801 N LAMAR BLVD
Practice Address - Street 2:STE D-74
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78752-1016
Practice Address - Country:US
Practice Address - Phone:512-452-4160
Practice Address - Fax:512-206-0808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU68005Medicare UPIN