Provider Demographics
NPI:1922142231
Name:GASPARINI, CARLA GAVILANES (OD)
Entity type:Individual
Prefix:DR
First Name:CARLA
Middle Name:GAVILANES
Last Name:GASPARINI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12407 N MO PAC EXPY STE 100
Mailing Address - Street 2:PMB 296
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-2429
Mailing Address - Country:US
Mailing Address - Phone:512-345-2595
Mailing Address - Fax:
Practice Address - Street 1:9300 S I H 35
Practice Address - Street 2:BLDG B
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-1733
Practice Address - Country:US
Practice Address - Phone:512-345-2595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5858 TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist