Provider Demographics
NPI:1316510647
Name:EYES OF TEXAS VISION THERAPY PLLC
Entity type:Organization
Organization Name:EYES OF TEXAS VISION THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:FERN
Authorized Official - Middle Name:
Authorized Official - Last Name:YEE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:512-454-5117
Mailing Address - Street 1:1518 W KOENIG LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-1416
Mailing Address - Country:US
Mailing Address - Phone:512-454-5117
Mailing Address - Fax:512-450-1496
Practice Address - Street 1:1518 W KOENIG LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-1416
Practice Address - Country:US
Practice Address - Phone:512-454-5117
Practice Address - Fax:512-450-1496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-23
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty