360 Vision PC
Organization Active NPI Optometrist · Austin, TX
NPI 1902011398 · NPPES record last updated Nov 17, 2010
Key facts
- NPI
- 1902011398
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 5146TG (TX)
- Legal business name
- 360 VISION PC
- Practice address
- 3808 Spicewood Springs Rd Ste 100
Austin, TX 78759-8964 - Phone
- (512) 328-0555
- Fax
- (512) 340-0009
- NPI assigned
- May 11, 2007
- Organization subpart
- No
Authorized official
- Name
- Laura Miller, O.D.
- Title
- President
- Phone
- (512) 328-0555
Practitioners 5
-
Laura Sanders Miller, O.D.
-
Meghan Anne Schutte, O.D.
-
Regina Budet, OTR
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101119000137 | TX | Part B Supplier - Clinic/Group Practice | 7810183654 |
Receives reassigned benefits from 5 practitioners Practice locations: Austin, TX |
National Provider Directory
Locations
3808 Spicewood Springs Rd
Ste 100
Austin, TX 78759
Phone (512) 328-0555
4512 S Pleasant Valley Rd
Austin, TX 78744
Phone (512) 328-0555
3921 Steck Ave
Ste A121
Austin, TX 78759
Phone (512) 328-0555
1545 Round Rock Ave
Ste 100A
Round Rock, TX 78681
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 5146TG | TX | Yes |
Addresses
Primary practice location
3808 Spicewood Springs Rd Ste 100
Austin, TX 78759-8964
Mailing address
3808 Spicewood Springs Rd Ste 100
Austin, TX 78759-8964
Phone (512) 328-0555
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0195224-01 | Medicaid | TX |
Other names
- Northwest Hills Eye Care
Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 17, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.