Provider Demographics
NPI:1750947891
Name:GAZE OPTOMETRY, PLLC
Entity type:Organization
Organization Name:GAZE OPTOMETRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:KAITY
Authorized Official - Middle Name:SHI
Authorized Official - Last Name:HOANG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:347-922-8158
Mailing Address - Street 1:4501 DESTINYS GATE DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78727-2630
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2701 S INTERSTATE 35
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-7320
Practice Address - Country:US
Practice Address - Phone:512-388-2600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-14
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty