MEDICARE: EPIC VISION CENTER PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	7055T	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033549555
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EPIC VISION CENTER PLLC

Provider Business Mailing Address
First Line	:	6626 W LOOP 1604 N STE 216
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78254-6602
Country	:	US
Telephone Number	:	210-647-4733
Fax Number	:	210-647-4741

Provider Business Practice Location Address
First Line	:	6626 W LOOP 1604 N STE 216
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78254-6602
Country	:	US
Telephone Number	:	210-647-4733
Fax Number	:	210-647-4741

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	DR. SUZANNE M JONES
Credential	:	OD
Telephone Number	:	210-858-7408

Provider Enumeration Date	:	11/19/2013
Last Update Date	:	08/09/2024

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Directions to “EPIC VISION CENTER PLLC ” Practice Location

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