Provider Demographics
NPI:1609751015
Name:AUSTER, MIA GABRIELLE (OD)
Entity type:Individual
Prefix:
First Name:MIA
Middle Name:GABRIELLE
Last Name:AUSTER
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 1:5787 COUNTY ROAD 2189
Mailing Address - Street 2:
Mailing Address - City:ODEM
Mailing Address - State:TX
Mailing Address - Zip Code:78370-4413
Mailing Address - Country:US
Mailing Address - Phone:361-290-9172
Mailing Address - Fax:
Practice Address - Street 1:15900 LA CANTERA PKWY STE 20215
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78256-2464
Practice Address - Country:US
Practice Address - Phone:210-354-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11498152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist