| Waterloo Eye Associates | |
|
12171 W Parmer Ln, Suite 201, Cedar Park, TX 78613-7361 | |
| (512) 528-1144 | |
| (512) 528-1143 |
| Full Name | Waterloo Eye Associates |
|---|---|
| Type | Facility |
| Speciality | Ophthalmology |
| Location | 12171 W Parmer Ln, Cedar Park, Texas |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407826415 | NPI | - | NPPES |
| 0059MS | Other | TX | BCBS OF TEXAS GROUP # |
| 173907001 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Secondary |
| 207W00000X | Ophthalmology | (* (Not Available)) | Primary |
| Provider Name | Peter T Wollan |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1205837432 PECOS PAC ID: 5597703017 Enrollment ID: I20050425000304 |
| Provider Name | Vincent A Restivo |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1811967821 PECOS PAC ID: 6709812746 Enrollment ID: I20050712000422 |
| Provider Name | Todd R Shepler |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1568453447 PECOS PAC ID: 2769558147 Enrollment ID: I20100507000706 |
| Provider Name | Kevin Soong |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1528589017 PECOS PAC ID: 9133472210 Enrollment ID: I20181019002412 |
| Provider Name | Nathan Evan Osterman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1437531381 PECOS PAC ID: 5991092272 Enrollment ID: I20190222000318 |
| Provider Name | Chelsea Anne Devitt |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1093236416 PECOS PAC ID: 9537427398 Enrollment ID: I20190712000998 |
| Mailing Address | Practice Location Address |
|---|---|
| Waterloo Eye Associates 12171 W Parmer Ln, Suite 201, Cedar Park, TX 78613-7361 Ph: (512) 528-1144 | Waterloo Eye Associates 12171 W Parmer Ln, Suite 201, Cedar Park, TX 78613-7361 Ph: (512) 528-1144 |