Provider Demographics
NPI:1669763645
Name:WESTLAKE EYECARE, PLLC
Entity type:Organization
Organization Name:WESTLAKE EYECARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:316-214-7443
Mailing Address - Street 1:4613 BEE CAVE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5203
Mailing Address - Country:US
Mailing Address - Phone:512-347-0700
Mailing Address - Fax:512-347-0702
Practice Address - Street 1:4613 BEE CAVE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-5203
Practice Address - Country:US
Practice Address - Phone:512-347-0700
Practice Address - Fax:512-347-0702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-26
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX07463TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty