Provider Demographics
NPI:1952747347
Name:DEVLYN OPTICAL, LLC
Entity Type:Organization
Organization Name:DEVLYN OPTICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:W
Authorized Official - Last Name:DEVLYN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:512-796-1966
Mailing Address - Street 1:2600 MCHALE CT
Mailing Address - Street 2:SUITE 180
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-4466
Mailing Address - Country:US
Mailing Address - Phone:512-796-1966
Mailing Address - Fax:512-551-0726
Practice Address - Street 1:2600 MCHALE CT
Practice Address - Street 2:SUITE 180
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-4466
Practice Address - Country:US
Practice Address - Phone:512-796-1966
Practice Address - Fax:512-551-0726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-13
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156F00000XEye and Vision Services ProvidersTechnician/TechnologistGroup - Single Specialty