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NPI Code Detail

MEDICARE: REFRACTIVE SURGERY & DIAGNOSTIC CENTER PLLC

MEDICARE: REFRACTIVE SURGERY & DIAGNOSTIC 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
1152W00000XOptometristTX
2207W00000XOphthalmology PhysicianTX

General Provider Information

NPI Number : 1639419013
Entity Type Code : Organization
Provider Name (Legal Business Name) : REFRACTIVE SURGERY & DIAGNOSTIC CENTER PLLC
Provider Business Mailing Address
First Line : 9725 DATAPOINT DR STE 106
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78229-2385
Country : US
Telephone Number : 210-615-9358
Fax Number :
Provider Business Practice Location Address
First Line : 9725 DATAPOINT DR STE 106
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78229-2385
Country : US
Telephone Number : 210-615-9358
Fax Number :
Authorized Official
Title or Position : OWNER
Name : GREGORY D. PARKHURST
Credential :
Telephone Number : 210-585-2020
Provider Enumeration Date : 02/22/2013
Last Update Date : 11/07/2022

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Directions to “REFRACTIVE SURGERY & DIAGNOSTIC CENTER PLLC ” Practice Location

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