Provider Demographics
NPI:1174577209
Name:AUSTIN-BILTZ, SAUNDRA MARIA (OD)
Entity type:Individual
Prefix:
First Name:SAUNDRA
Middle Name:MARIA
Last Name:AUSTIN-BILTZ
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:SAUNDRA
Other - Middle Name:M
Other - Last Name:AUSTIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:3621 WILLIAM PENN HWY
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-2123
Mailing Address - Country:US
Mailing Address - Phone:412-372-4236
Mailing Address - Fax:
Practice Address - Street 1:3621 WILLIAM PENN HWY
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2123
Practice Address - Country:US
Practice Address - Phone:412-372-4236
Practice Address - Fax:412-372-4259
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-22
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA008920152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA10888982Medicaid
AU001402701OtherHIGHMARK BCBS
PA10888982Medicaid
AU001402701OtherHIGHMARK BCBS