Provider Demographics
NPI:1316260185
Name:PAK FAMILY EYE CARE
Entity type:Organization
Organization Name:PAK FAMILY EYE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:HYUN
Authorized Official - Last Name:PAK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:512-891-9969
Mailing Address - Street 1:4301 WEST WILLIAM CANNON DRIVE
Mailing Address - Street 2:BUILDING A SUITE 100
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749
Mailing Address - Country:US
Mailing Address - Phone:512-891-9969
Mailing Address - Fax:
Practice Address - Street 1:4301 W WILLIAM CANNON DR
Practice Address - Street 2:BUILDING A SUITE 100
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78749-1473
Practice Address - Country:US
Practice Address - Phone:512-891-9969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-09
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX7379TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty