Provider Demographics
NPI:1174717854
Name:MICHAEL P HOBUSS, OPTOMETRIST, P.C.
Entity type:Organization
Organization Name:MICHAEL P HOBUSS, OPTOMETRIST, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOBUSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-670-2600
Mailing Address - Street 1:15300 FM 1825
Mailing Address - Street 2:SUITE 111
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-2603
Mailing Address - Country:US
Mailing Address - Phone:512-670-2600
Mailing Address - Fax:512-670-2667
Practice Address - Street 1:15300 FM 1825 # B
Practice Address - Street 2:SUITE 111
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-2603
Practice Address - Country:US
Practice Address - Phone:512-670-2600
Practice Address - Fax:512-670-2667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX2572T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1043211535OtherNPI
TXVISION INSURER IDOtherTX2572
TXVISION INSURER IDOtherTX2572
TXT13857Medicare UPIN
TX0414030001Medicare NSC