Provider Demographics
NPI:1952786071
Name:ALI VISION CARE PLLC
Entity Type:Organization
Organization Name:ALI VISION CARE PLLC
Other - Org Name:RANCH ROAD VISION SOURCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAZEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:512-893-2020
Mailing Address - Street 1:7300 RANCH ROAD 2222 STE 112
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78730-3204
Mailing Address - Country:US
Mailing Address - Phone:512-893-2020
Mailing Address - Fax:
Practice Address - Street 1:7300 RANCH ROAD 2222 STE 112
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78730-3204
Practice Address - Country:US
Practice Address - Phone:512-893-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-30
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8151152W00000X
152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty