Provider Demographics
NPI:1144598350
Name:DIANE L YU-DAVIS PA
Entity type:Organization
Organization Name:DIANE L YU-DAVIS PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:L
Authorized Official - Last Name:YU-DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:512-454-4401
Mailing Address - Street 1:6406 N IH 35
Mailing Address - Street 2:SUITE 1250
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78752-4352
Mailing Address - Country:US
Mailing Address - Phone:512-454-4401
Mailing Address - Fax:512-458-4018
Practice Address - Street 1:6406 N IH 35
Practice Address - Street 2:SUITE 1250
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78752-4352
Practice Address - Country:US
Practice Address - Phone:512-454-4401
Practice Address - Fax:512-458-4018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-02
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7703T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty